How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $50,119Professionalmedian $1,862 · 10th to 90th $1,413 to $11,749
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 $1,737.80 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,737.80 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,621.81 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $11,220.18 Typical High $22,387.21 | Facility | None | $6,760.83 | $11,220.18 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,949.84 Typical High $6,309.57 | Professional | None | $1,819.70 | $1,949.84 | $6,309.57 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,265.80 Typical High $8,912.51 | Facility | None | $67.61 | $4,265.80 | $8,912.51 |
Blue Shield Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $4,073.80 | Professional | None | $1,148.15 | $1,659.59 | $4,073.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,778.28 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,778.28 | $4,466.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,659.59 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $4,265.80 | Professional | None | $1,412.54 | $1,778.28 | $4,265.80 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,022.64 | Professional | None | $11,748.98 | $11,748.98 | $12,022.64 |
Molina Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,698.24 | $4,466.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
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 $1,258.93 Median $1,737.80 Typical High $4,677.35 | Professional | None | $1,258.93 | $1,737.80 | $4,677.35 |
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 $758.58 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,047.13 Typical High $2,344.23 | Professional | 62 · Two surgeons | $831.76 | $1,047.13 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $263.03 Typical High $602.56 | Professional | 80 · Assistant surgeon | $208.93 | $263.03 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $234.42 Typical High $524.81 | Professional | AS · PA/NP assist | $181.97 | $234.42 | $524.81 |
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· 28th of 51
$2,042
AK $6,457TX $1,096
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.