How much rates vary
Facilitymedian $5,248 · 10th to 90th $676 to $26,915Professionalmedian $4,898 · 10th to 90th $3,890 to $34,674
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 $3,467.37 Median $7,585.78 Typical High $18,197.01 | Facility | None | $3,467.37 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $4,168.69 Median $4,466.84 Typical High $6,606.93 | Professional | None | $4,168.69 | $4,466.84 | $6,606.93 |
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 $4,073.80 Median $4,897.79 Typical High $8,128.31 | Professional | None | $4,073.80 | $4,897.79 | $8,128.31 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,089.30 Typical High $14,454.40 | Facility | None | $95.50 | $2,089.30 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $3,162.28 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,162.28 | $4,570.88 | $5,623.41 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $954.99 Median $5,248.07 Typical High $5,248.07 | Professional | None | $954.99 | $5,248.07 | $5,248.07 |
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 $4,365.16 Median $4,897.79 Typical High $7,585.78 | Professional | None | $4,365.16 | $4,897.79 | $7,585.78 |
Contra Costa Health Setting Professional Modifier None Typical Low $630.96 Median $4,677.35 Typical High $5,128.61 | Professional | None | $630.96 | $4,677.35 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $10,000.00 | Professional | None | $4,073.80 | $4,466.84 | $10,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $34,673.69 Median $39,810.72 Typical High $39,810.72 | Professional | None | $34,673.69 | $39,810.72 | $39,810.72 |
Molina Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Professional | None | $7,244.36 | $7,244.36 | $7,244.36 |
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 $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $4,365.16 Median $4,897.79 Typical High $7,079.46 | Professional | None | $4,365.16 | $4,897.79 | $7,079.46 |
Sutter Health Plus Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $15,848.93 | Professional | None | $15,848.93 | $15,848.93 | $15,848.93 |
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 $3,890.45 Median $4,786.30 Typical High $7,585.78 | Professional | None | $3,890.45 | $4,786.30 | $7,585.78 |
10 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 $2,089.30 Median $2,238.72 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,089.30 | $2,238.72 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $891.25 Typical High $977.24 | Professional | 53 · Discontinued | $831.76 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $3,311.31 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,162.28 | $3,311.31 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | 55 · Aftercare only | $630.96 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $446.68 Typical High $489.78 | Professional | 56 · Pre-op care only | $416.87 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $3,090.30 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,951.21 | $3,090.30 | $3,467.37 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | 58 · Staged procedure | $6,025.60 | $6,025.60 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,398.83 Median $2,951.21 Typical High $5,370.32 | Professional | 62 · Two surgeons | $2,398.83 | $2,951.21 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $758.58 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $602.56 | $758.58 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $660.69 Typical High $1,202.26 | Professional | AS · PA/NP assist | $524.81 | $660.69 | $1,202.26 |
Where California sits
The same service costs 20.0 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· 40th of 51
$4,898
AK $15,488TX $776
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.