How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $50,119Professionalmedian $1,047 · 10th to 90th $794 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 $1,000.00 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,000.00 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,047.13 | Professional | None | $912.01 | $1,000.00 | $1,047.13 |
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 $1,000.00 Median $1,122.02 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,122.02 | $3,548.13 |
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 $660.69 Median $954.99 Typical High $2,344.23 | Professional | None | $660.69 | $954.99 | $2,344.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,412.54 | Professional | None | $812.83 | $1,000.00 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $2,454.71 | Professional | None | $831.76 | $977.24 | $2,454.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,122.02 | Professional | None | $741.31 | $954.99 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $2,041.74 | Professional | None | $812.83 | $1,000.00 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,760.83 | Professional | None | $6,606.93 | $6,606.93 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $2,454.71 | Professional | None | $831.76 | $933.25 | $2,454.71 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $691.83 Median $1,000.00 Typical High $2,630.27 | Professional | None | $691.83 | $1,000.00 | $2,630.27 |
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 $446.68 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,380.38 Typical High $3,090.30 | Professional | 50 · Both sides | $1,096.48 | $1,380.38 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $575.44 Typical High $1,318.26 | Professional | 62 · Two surgeons | $457.09 | $575.44 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $147.91 Typical High $331.13 | Professional | 80 · Assistant surgeon | $114.82 | $147.91 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $128.82 Typical High $288.40 | Professional | AS · PA/NP assist | $102.33 | $128.82 | $288.40 |
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· 31st of 51
$1,122
AK $3,548UT $631
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.