How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $50,119Professionalmedian $1,738 · 10th to 90th $1,413 to $12,303
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 $1,778.28 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,778.28 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,584.89 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,495.41 Median $9,332.54 Typical High $19,498.45 | Facility | None | $5,495.41 | $9,332.54 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,737.80 | $2,951.21 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,168.69 Typical High $8,709.64 | Facility | None | $67.61 | $4,168.69 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,698.24 | $2,089.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,949.84 | $2,398.83 |
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 $1,513.56 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,698.24 | $2,691.53 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,737.80 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,659.59 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $14,125.38 Typical High $14,125.38 | Professional | None | $12,302.69 | $14,125.38 | $14,125.38 |
Molina Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $1,513.56 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,698.24 | $2,511.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
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 $1,380.38 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,698.24 | $2,691.53 |
8 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 $741.31 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $275.42 Typical High $537.03 | Professional | 80 · Assistant surgeon | $223.87 | $275.42 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $245.47 Typical High $467.74 | Professional | AS · PA/NP assist | $199.53 | $245.47 | $467.74 |
Where California sits
The same service costs 5.4 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
$1,738
AK $6,026TX $1,122
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.