How much rates vary
Facilitymedian $3,981 · 10th to 90th $955 to $10,233Professionalmedian $1,047 · 10th to 90th $759 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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $2,570.40 | Professional | None | $870.96 | $933.25 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $3,467.37 | Professional | None | $1,000.00 | $1,096.48 | $3,467.37 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,884.03 Typical High $7,413.10 | Facility | None | $100.00 | $2,884.03 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $2,290.87 | Professional | None | $660.69 | $933.25 | $2,290.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,122.02 | Professional | None | $741.31 | $977.24 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $3,981.07 Typical High $6,918.31 | Facility | None | $575.44 | $3,981.07 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $2,398.83 | Professional | None | $812.83 | $954.99 | $2,398.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,071.52 | Professional | None | $588.84 | $891.25 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,995.26 | Professional | None | $794.33 | $1,000.00 | $1,995.26 |
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 $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $3,715.35 Typical High $6,918.31 | Facility | None | $724.44 | $3,715.35 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $2,398.83 | Professional | None | $812.83 | $933.25 | $2,398.83 |
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 $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $2,570.40 | Professional | None | $676.08 | $977.24 | $2,570.40 |
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 $436.52 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $190.55 | $194.98 |
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 $87.10 Median $93.33 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $97.72 |
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 62 · Two surgeons Typical Low $407.38 Median $537.03 Typical High $1,288.25 | Professional | 62 · Two surgeons | $407.38 | $537.03 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $134.90 Typical High $323.59 | Professional | 80 · Assistant surgeon | $104.71 | $134.90 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $117.49 Typical High $288.40 | Professional | AS · PA/NP assist | $91.20 | $117.49 | $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· 26th of 51
$1,318
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.