How much rates vary
Facilitymedian $4,365 · 10th to 90th $661 to $28,840Professionalmedian $1,230 · 10th to 90th $933 to $5,248
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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $3,801.89 | Professional | None | $1,096.48 | $1,148.15 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $12,022.64 Typical High $23,442.29 | Facility | None | $7,244.36 | $12,022.64 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $4,365.16 | Professional | None | $1,202.26 | $1,318.26 | $4,365.16 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,691.53 Typical High $6,025.60 | Facility | None | $95.50 | $2,691.53 | $6,025.60 |
Blue Shield Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,884.03 | Professional | None | $831.76 | $1,202.26 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,230.27 | $2,089.30 |
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 $1,096.48 Median $1,202.26 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,202.26 | $3,019.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,202.26 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $2,454.71 | Professional | None | $977.24 | $1,230.27 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,471.29 | Professional | None | $10,471.29 | $10,471.29 | $10,471.29 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,096.48 Median $1,202.26 Typical High $3,019.95 | Professional | None | $1,096.48 | $1,202.26 | $3,019.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
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 $870.96 Median $1,202.26 Typical High $3,162.28 | Professional | None | $870.96 | $1,202.26 | $3,162.28 |
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 $537.03 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $537.03 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $707.95 Typical High $1,584.89 | Professional | 62 · Two surgeons | $562.34 | $707.95 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $177.83 Typical High $407.38 | Professional | 80 · Assistant surgeon | $141.25 | $177.83 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $158.49 Typical High $354.81 | Professional | AS · PA/NP assist | $123.03 | $158.49 | $354.81 |
Where California sits
The same service costs 5.9 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· 30th of 51
$1,413
AK $4,365TX $741
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.