How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $56,234Professionalmedian $1,738 · 10th to 90th $1,288 to $10,471
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 $1,621.81 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,621.81 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,479.11 | $1,548.82 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $11,220.18 Typical High $22,387.21 | Facility | None | $6,760.83 | $11,220.18 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $5,754.40 | Professional | None | $1,659.59 | $1,862.09 | $5,754.40 |
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 $1,122.02 Median $1,584.89 Typical High $3,801.89 | Professional | None | $1,122.02 | $1,584.89 | $3,801.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,621.81 | $2,089.30 |
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 $1,380.38 Median $1,584.89 Typical High $4,073.80 | Professional | None | $1,380.38 | $1,584.89 | $4,073.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,445.44 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,288.25 | $1,621.81 | $3,311.31 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,964.78 | Professional | None | $10,471.29 | $10,471.29 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,380.38 Median $1,548.82 Typical High $4,073.80 | Professional | None | $1,380.38 | $1,548.82 | $4,073.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
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 $1,148.15 Median $1,621.81 Typical High $4,265.80 | Professional | None | $1,148.15 | $1,621.81 | $4,265.80 |
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 $724.44 Median $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $724.44 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $288.40 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $245.47 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $144.54 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,238.72 Typical High $5,128.61 | Professional | 50 · Both sides | $1,778.28 | $2,238.72 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $954.99 Typical High $2,137.96 | Professional | 62 · Two surgeons | $741.31 | $954.99 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $239.88 Typical High $537.03 | Professional | 80 · Assistant surgeon | $190.55 | $239.88 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $478.63 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $478.63 |
Where California sits
The same service costs 5.9 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· 30th of 51
$1,862
AK $5,888TX $1,000
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.