How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $50,119Professionalmedian $1,514 · 10th to 90th $1,175 to $6,607
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 $1,380.38 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,380.38 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,348.96 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $9,332.54 Typical High $19,054.61 | Facility | None | $5,370.32 | $9,332.54 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $5,248.07 | Professional | None | $1,412.54 | $1,584.89 | $5,248.07 |
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 $954.99 Median $1,348.96 Typical High $3,311.31 | Professional | None | $954.99 | $1,348.96 | $3,311.31 |
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 $1,288.25 Median $1,445.44 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,445.44 | $3,715.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,445.44 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,621.81 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,288.25 Median $1,412.54 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,412.54 | $3,801.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $1,096.48 Median $1,548.82 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,548.82 | $4,073.80 |
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 $645.65 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $257.04 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $891.25 Typical High $2,137.96 | Professional | 62 · Two surgeons | $724.44 | $891.25 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $229.09 Typical High $549.54 | Professional | 80 · Assistant surgeon | $181.97 | $229.09 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $199.53 Typical High $478.63 | Professional | AS · PA/NP assist | $158.49 | $199.53 | $478.63 |
Where California sits
The same service costs 21.4 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· 33rd of 51
$1,622
AK $5,754TX $269
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.