How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $50,119Professionalmedian $1,047 · 10th to 90th $851 to $7,413
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 $1,047.13 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,047.13 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Professional | None | $891.25 | $933.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,120.11 Typical High $19,054.61 | Facility | None | $5,495.41 | $9,120.11 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,023.29 | $1,778.28 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,230.27 | Professional | None | $707.95 | $1,000.00 | $1,230.27 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | None | $912.01 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,621.81 | Professional | None | $912.01 | $1,047.13 | $1,621.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $1,230.27 | Professional | None | $616.60 | $1,122.02 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $2,187.76 | Professional | None | $933.25 | $1,047.13 | $2,187.76 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $8,912.51 Typical High $8,912.51 | Professional | None | $7,413.10 | $8,912.51 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $912.01 Median $1,047.13 Typical High $1,548.82 | Professional | None | $912.01 | $1,047.13 | $1,548.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $831.76 Median $1,047.13 Typical High $1,621.81 | Professional | None | $831.76 | $1,047.13 | $1,621.81 |
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 $446.68 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $794.33 | Professional | 54 · Surgery only | $660.69 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $741.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $676.08 Typical High $1,288.25 | Professional | 62 · Two surgeons | $537.03 | $676.08 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $169.82 Typical High $323.59 | Professional | 80 · Assistant surgeon | $138.04 | $169.82 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $147.91 Typical High $281.84 | Professional | AS · PA/NP assist | $120.23 | $147.91 | $281.84 |
Where California sits
The same service costs 24.5 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· 41st of 51
$1,047
AK $4,266TX $174
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.