How much rates vary
Facilitymedian $7,586 · 10th to 90th $1,318 to $19,055Professionalmedian $1,259 · 10th to 90th $1,000 to $8,913
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 $2,630.27 Median $8,317.64 Typical High $18,197.01 | Facility | None | $2,630.27 | $8,317.64 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,715.19 Typical High $19,498.45 | Facility | None | $5,248.07 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,230.27 | $2,137.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $3,548.13 Typical High $17,378.01 | Facility | None | $100.00 | $3,548.13 | $17,378.01 |
Blue Shield Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,479.11 | Professional | None | $851.14 | $1,202.26 | $1,479.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,122.02 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $7,585.78 Typical High $15,488.17 | Facility | None | $758.58 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,230.27 | $1,905.46 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,412.54 | Professional | None | $741.31 | $1,288.25 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,202.26 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $10,471.29 Typical High $10,471.29 | Professional | None | $8,912.51 | $10,471.29 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $831.76 Median $7,244.36 Typical High $14,791.08 | Facility | None | $831.76 | $7,244.36 | $14,791.08 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,230.27 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $29,512.09 | Facility | None | $4,265.80 | $9,772.37 | $29,512.09 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,905.46 | Professional | None | $977.24 | $1,230.27 | $1,905.46 |
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 $537.03 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $724.44 Typical High $1,513.56 | Professional | 62 · Two surgeons | $588.84 | $724.44 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $186.21 Typical High $389.05 | Professional | 80 · Assistant surgeon | $147.91 | $186.21 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $338.84 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $338.84 |
Where California sits
The same service costs 25.7 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· 39th of 51
$1,259
AK $5,129TX $200
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.