How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,122 to $151,356Professionalmedian $1,622 · 10th to 90th $1,230 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 $1,548.82 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,548.82 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,479.11 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $10,964.78 Typical High $22,387.21 | Facility | None | $6,456.54 | $10,964.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $5,495.41 | Professional | None | $1,584.89 | $1,778.28 | $5,495.41 |
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 $1,047.13 Median $1,479.11 Typical High $3,630.78 | Professional | None | $1,047.13 | $1,479.11 | $3,630.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,548.82 | $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 $1,318.26 Median $1,548.82 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,548.82 | $3,890.45 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,380.38 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,715.35 | Professional | None | $1,230.27 | $1,548.82 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $12,589.25 Typical High $12,589.25 | Professional | None | $10,471.29 | $12,589.25 | $12,589.25 |
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 |
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 $1,318.26 Median $1,479.11 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,479.11 | $3,890.45 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,548.82 | $4,073.80 |
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 $691.83 Median $741.31 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,187.76 Typical High $4,897.79 | Professional | 50 · Both sides | $1,698.24 | $2,187.76 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $912.01 Typical High $2,041.74 | Professional | 62 · Two surgeons | $707.95 | $912.01 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $234.42 Typical High $512.86 | Professional | 80 · Assistant surgeon | $181.97 | $234.42 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $204.17 Typical High $457.09 | Professional | AS · PA/NP assist | $158.49 | $204.17 | $457.09 |
Where California sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 32nd of 51
$1,820
AK $5,623UT $977
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.