How much rates vary
Facilitymedian $5,623 · 10th to 90th $617 to $151,356Professionalmedian $4,169 · 10th to 90th $3,388 to $30,200
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 $3,548.13 Median $8,128.31 Typical High $19,054.61 | Facility | None | $3,548.13 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,548.13 Typical High $4,168.69 | Professional | None | $3,388.44 | $3,548.13 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $11,481.54 Typical High $21,379.62 | Facility | None | $5,370.32 | $11,481.54 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,890.45 Median $3,981.07 Typical High $7,244.36 | Professional | None | $3,890.45 | $3,981.07 | $7,244.36 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $6,760.83 Typical High $14,125.38 | Facility | None | $67.61 | $6,760.83 | $14,125.38 |
Blue Shield Setting Professional Modifier None Typical Low $2,818.38 Median $3,981.07 Typical High $4,897.79 | Professional | None | $2,818.38 | $3,981.07 | $4,897.79 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3,162.28 Median $4,786.30 Typical High $4,786.30 | Professional | None | $3,162.28 | $4,786.30 | $4,786.30 |
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 $3,630.78 Median $4,168.69 Typical High $6,456.54 | Professional | None | $3,630.78 | $4,168.69 | $6,456.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,137.96 Median $4,265.80 Typical High $4,677.35 | Professional | None | $2,137.96 | $4,265.80 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $8,317.64 | Professional | None | $3,630.78 | $4,073.80 | $8,317.64 |
Lucent Health Setting Professional Modifier None Typical Low $30,199.52 Median $34,673.69 Typical High $34,673.69 | Professional | None | $30,199.52 | $34,673.69 | $34,673.69 |
Molina Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
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 $3,630.78 Median $4,168.69 Typical High $6,165.95 | Professional | None | $3,630.78 | $4,168.69 | $6,165.95 |
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 $3,311.31 Median $4,073.80 Typical High $6,456.54 | Professional | None | $3,311.31 | $4,073.80 | $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 $1,698.24 Median $1,778.28 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,698.24 | $1,778.28 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $812.83 | Professional | 53 · Discontinued | $676.08 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,630.27 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,570.40 | $2,630.27 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $537.03 Typical High $616.60 | Professional | 55 · Aftercare only | $512.86 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $354.81 Typical High $407.38 | Professional | 56 · Pre-op care only | $338.84 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,454.71 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,454.71 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,187.76 Median $2,691.53 Typical High $5,011.87 | Professional | 62 · Two surgeons | $2,187.76 | $2,691.53 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $691.83 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $549.54 | $691.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $489.78 Median $602.56 Typical High $1,122.02 | Professional | AS · PA/NP assist | $489.78 | $602.56 | $1,122.02 |
Where California sits
The same service costs 20.9 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· 43rd of 51
$4,169
AK $14,125TX $676
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.