How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $50,119Professionalmedian $1,349 · 10th to 90th $1,000 to $8,318
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 $1,258.93 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,258.93 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,202.26 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $9,120.11 Typical High $19,054.61 | Facility | None | $5,370.32 | $9,120.11 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $4,570.88 | Professional | None | $1,288.25 | $1,412.54 | $4,570.88 |
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 $870.96 Median $1,258.93 Typical High $3,019.95 | Professional | None | $870.96 | $1,258.93 | $3,019.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,288.25 | $1,778.28 |
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 $1,071.52 Median $1,258.93 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,258.93 | $3,162.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,412.54 | Professional | None | $933.25 | $1,174.90 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,288.25 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,709.64 | Professional | None | $8,317.64 | $8,317.64 | $8,709.64 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $1,071.52 Median $1,202.26 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,202.26 | $3,162.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
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 $891.25 Median $1,288.25 Typical High $3,388.44 | Professional | None | $891.25 | $1,288.25 | $3,388.44 |
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 $575.44 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $229.09 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $758.58 Typical High $1,698.24 | Professional | 62 · Two surgeons | $588.84 | $758.58 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $426.58 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $165.96 Typical High $371.54 | Professional | AS · PA/NP assist | $131.83 | $165.96 | $371.54 |
Where California sits
The same service costs 5.8 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· 31st of 51
$1,479
AK $4,677TX $813
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.