How much rates vary
Facilitymedian $5,495 · 10th to 90th $631 to $50,119Professionalmedian $1,318 · 10th to 90th $1,072 to $9,550
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 $1,318.26 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,318.26 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,202.26 | $1,318.26 |
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 $1,230.27 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,288.25 | $2,238.72 |
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 $794.33 Median $1,148.15 Typical High $1,412.54 | Professional | None | $794.33 | $1,148.15 | $1,412.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,513.56 | $1,513.56 |
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 $1,148.15 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,318.26 | $2,041.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $1,513.56 | Professional | None | $741.31 | $1,348.96 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,288.25 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $11,220.18 Typical High $11,220.18 | Professional | None | $9,549.93 | $11,220.18 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,148.15 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,318.26 | $1,949.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $1,047.13 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,318.26 | $2,041.74 |
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 $562.34 Median $602.56 Typical High $660.69 | Professional | 52 · Reduced service | $562.34 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $223.87 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $831.76 Typical High $1,621.81 | Professional | 62 · Two surgeons | $691.83 | $831.76 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $213.80 Typical High $407.38 | Professional | 80 · Assistant surgeon | $173.78 | $213.80 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $354.81 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $354.81 |
Where California sits
The same service costs 5.2 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
$1,318
AK $4,677TX $891
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.