How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,023 to $12,023Professionalmedian $1,148 · 10th to 90th $851 to $4,571
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 $933.25 Median $1,000.00 Typical High $1,949.84 | Professional | None | $933.25 | $1,000.00 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,000.00 Typical High $18,620.87 | Facility | None | $4,570.88 | $10,000.00 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $3,801.89 | Professional | None | $1,148.15 | $1,230.27 | $3,801.89 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,691.53 Typical High $7,585.78 | Facility | None | $100.00 | $2,691.53 | $7,585.78 |
Blue Shield Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $2,454.71 | Professional | None | $707.95 | $1,000.00 | $2,454.71 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,621.81 | Professional | None | $870.96 | $1,047.13 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,584.89 Typical High $3,311.31 | Facility | None | $645.65 | $1,584.89 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $2,630.27 | Professional | None | $977.24 | $1,047.13 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,288.25 | Professional | None | $851.14 | $1,047.13 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $2,511.89 | Professional | None | $851.14 | $1,047.13 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
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 $1,659.59 Typical High $5,623.41 | Facility | None | $758.58 | $1,659.59 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $2,630.27 | Professional | None | $954.99 | $1,047.13 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,265.80 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,265.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,754.23 | Professional | None | $758.58 | $1,047.13 | $2,754.23 |
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 $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $138.04 | $151.36 | $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 $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $707.95 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $616.60 Typical High $1,380.38 | Professional | 62 · Two surgeons | $478.63 | $616.60 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $158.49 Typical High $346.74 | Professional | 80 · Assistant surgeon | $120.23 | $158.49 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $138.04 Typical High $302.00 | Professional | AS · PA/NP assist | $107.15 | $138.04 | $302.00 |
Where California sits
The same service costs 5.6 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· 26th of 51
$1,349
AK $3,715TX $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.