How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $50,119Professionalmedian $3,981 · 10th to 90th $3,311 to $33,113
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,467.37 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,467.37 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,311.31 Median $3,467.37 Typical High $3,981.07 | Professional | None | $3,311.31 | $3,467.37 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $8,317.64 Typical High $18,197.01 | Facility | None | $4,265.80 | $8,317.64 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $3,981.07 Typical High $6,760.83 | Professional | None | $3,467.37 | $3,981.07 | $6,760.83 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $9,549.93 Typical High $19,498.45 | Facility | None | $67.61 | $9,549.93 | $19,498.45 |
Blue Shield Setting Professional Modifier None Typical Low $2,570.40 Median $3,715.35 Typical High $4,570.88 | Professional | None | $2,570.40 | $3,715.35 | $4,570.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,884.03 Median $4,677.35 Typical High $4,677.35 | Professional | None | $2,884.03 | $4,677.35 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,801.89 Typical High $6,456.54 | Professional | None | $3,467.37 | $3,801.89 | $6,456.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,905.46 Median $4,168.69 Typical High $4,570.88 | Professional | None | $1,905.46 | $4,168.69 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,548.13 Median $3,981.07 Typical High $8,128.31 | Professional | None | $3,548.13 | $3,981.07 | $8,128.31 |
Lucent Health Setting Professional Modifier None Typical Low $33,113.11 Median $34,673.69 Typical High $34,673.69 | Professional | None | $33,113.11 | $34,673.69 | $34,673.69 |
Molina Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $3,467.37 Median $3,801.89 Typical High $6,025.60 | Professional | None | $3,467.37 | $3,801.89 | $6,025.60 |
Sutter Health Plus Setting Professional Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Professional | None | $13,489.63 | $13,489.63 | $13,489.63 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $6,456.54 | Professional | None | $3,235.94 | $3,890.45 | $6,456.54 |
9 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,737.80 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,659.59 | $1,737.80 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $691.83 Typical High $794.33 | Professional | 53 · Discontinued | $660.69 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $588.84 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $346.74 Typical High $398.11 | Professional | 56 · Pre-op care only | $331.13 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,454.71 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,454.71 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,511.89 Typical High $4,365.16 | Professional | 62 · Two surgeons | $1,995.26 | $2,511.89 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $645.65 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $512.86 | $645.65 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $562.34 Typical High $977.24 | Professional | AS · PA/NP assist | $446.68 | $562.34 | $977.24 |
Where California sits
The same service costs 21.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
California· 42nd of 51
$3,981
AK $14,125TX $646
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.