How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $50,119Professionalmedian $1,122 · 10th to 90th $912 to $8,128
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 $1,148.15 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,148.15 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $1,148.15 | Professional | None | $977.24 | $1,023.29 | $1,148.15 |
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 $1,096.48 Median $1,096.48 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,096.48 | $1,949.84 |
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 $1,023.29 Typical High $1,258.93 | Professional | None | $707.95 | $1,023.29 | $1,258.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,348.96 | Professional | None | $912.01 | $1,348.96 | $1,348.96 |
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 $977.24 Median $1,148.15 Typical High $1,778.28 | Professional | None | $977.24 | $1,148.15 | $1,778.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,318.26 | Professional | None | $616.60 | $1,202.26 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,122.02 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $8,128.31 Median $9,549.93 Typical High $9,549.93 | Professional | None | $8,128.31 | $9,549.93 | $9,549.93 |
Molina Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $977.24 Median $1,148.15 Typical High $1,698.24 | Professional | None | $977.24 | $1,148.15 | $1,698.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $912.01 Median $1,122.02 Typical High $1,778.28 | Professional | None | $912.01 | $1,122.02 | $1,778.28 |
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 $478.63 Median $512.86 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $204.17 Typical High $229.09 | Professional | 53 · Discontinued | $194.98 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $97.72 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $707.95 Typical High $1,380.38 | Professional | 62 · Two surgeons | $588.84 | $707.95 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $354.81 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $158.49 Typical High $309.03 | Professional | AS · PA/NP assist | $131.83 | $158.49 | $309.03 |
Where California sits
The same service costs 5.6 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
$1,122
AK $4,266TX $759
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.