How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $50,119Professionalmedian $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 $1,412.54 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,513.56 | $1,737.80 |
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 $1,548.82 Median $1,698.24 Typical High $5,495.41 | Professional | None | $1,548.82 | $1,698.24 | $5,495.41 |
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 $1,000.00 Median $1,412.54 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,412.54 | $3,548.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,659.59 | $1,905.46 |
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 $1,348.96 Median $1,513.56 Typical High $3,890.45 | Professional | None | $1,348.96 | $1,513.56 | $3,890.45 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,479.11 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,698.24 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $12,022.64 | Professional | None | $10,471.29 | $10,471.29 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,348.96 Median $1,513.56 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,513.56 | $3,981.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 |
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 $707.95 Median $758.58 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,122.02 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $223.87 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,047.13 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,047.13 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $933.25 Typical High $2,238.72 | Professional | 62 · Two surgeons | $758.58 | $933.25 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $245.47 Typical High $575.44 | Professional | 80 · Assistant surgeon | $190.55 | $245.47 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $501.19 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $501.19 |
Where California sits
The same service costs 5.6 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
$1,778
AK $6,026UT $1,072
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.