How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $56,234Professionalmedian $1,202 · 10th to 90th $912 to $7,586
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 $1,023.29 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,023.29 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,258.93 | Professional | None | $954.99 | $1,000.00 | $1,258.93 |
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 $1,096.48 Median $1,230.27 Typical High $3,981.07 | Professional | None | $1,096.48 | $1,230.27 | $3,981.07 |
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 $776.25 Median $1,122.02 Typical High $2,754.23 | Professional | None | $776.25 | $1,122.02 | $2,754.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,348.96 | Professional | None | $912.01 | $1,230.27 | $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 $954.99 Median $1,122.02 Typical High $2,818.38 | Professional | None | $954.99 | $1,122.02 | $2,818.38 |
Contra Costa Health Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,348.96 | Professional | None | $724.44 | $1,122.02 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,000.00 | $1,258.93 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,912.51 | Professional | None | $7,585.78 | $7,585.78 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $954.99 Median $1,096.48 Typical High $2,884.03 | Professional | None | $954.99 | $1,096.48 | $2,884.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $851.14 Median $1,174.90 Typical High $3,162.28 | Professional | None | $851.14 | $1,174.90 | $3,162.28 |
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 $478.63 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,621.81 Typical High $3,981.07 | Professional | 50 · Both sides | $1,318.26 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $691.83 Typical High $1,659.59 | Professional | 62 · Two surgeons | $549.54 | $691.83 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $181.97 Typical High $416.87 | Professional | 80 · Assistant surgeon | $141.25 | $181.97 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $151.36 Typical High $371.54 | Professional | AS · PA/NP assist | $123.03 | $151.36 | $371.54 |
Where California sits
The same service costs 6.6 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· 30th of 51
$1,349
AK $4,365TX $661
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.