How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,259 to $12,589Professionalmedian $1,122 · 10th to 90th $851 to $6,918
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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,318.26 | Professional | None | $954.99 | $1,071.52 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,481.54 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,481.54 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $3,890.45 | Professional | None | $1,096.48 | $1,202.26 | $3,890.45 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $8,709.64 | Facility | None | $100.00 | $2,691.53 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $2,511.89 | Professional | None | $724.44 | $1,023.29 | $2,511.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,071.52 | Professional | None | $562.34 | $870.96 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $7,244.36 Typical High $12,302.69 | Facility | None | $645.65 | $7,244.36 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,630.27 | Professional | None | $891.25 | $1,047.13 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $446.68 Median $954.99 Typical High $1,148.15 | Professional | None | $446.68 | $954.99 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $2,570.40 | Professional | None | $851.14 | $1,071.52 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $7,244.36 | Professional | None | $6,918.31 | $6,918.31 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $11,220.18 | Facility | None | $758.58 | $6,165.95 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $2,630.27 | Professional | None | $891.25 | $1,023.29 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $10,471.29 | Facility | None | $1,318.26 | $1,318.26 | $10,471.29 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,818.38 | Professional | None | $758.58 | $1,047.13 | $2,818.38 |
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 $467.74 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $213.80 | Professional | 53 · Discontinued | $186.21 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $630.96 Typical High $1,380.38 | Professional | 62 · Two surgeons | $489.78 | $630.96 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $158.49 Typical High $354.81 | Professional | 80 · Assistant surgeon | $123.03 | $158.49 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $138.04 Typical High $309.03 | Professional | AS · PA/NP assist | $107.15 | $138.04 | $309.03 |
Where California sits
The same service costs 6.3 times more in Oklahoma 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· 30th of 51
$1,318
OK $4,169UT $661
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.