How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $50,119Professionalmedian $1,000 · 10th to 90th $708 to $6,026
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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $912.01 | Professional | None | $724.44 | $831.76 | $912.01 |
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 $741.31 Median $1,047.13 Typical High $3,235.94 | Professional | None | $741.31 | $1,047.13 | $3,235.94 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $3,090.30 Typical High $6,606.93 | Facility | None | $67.61 | $3,090.30 | $6,606.93 |
Blue Shield Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,238.72 | Professional | None | $645.65 | $912.01 | $2,238.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $660.69 Median $912.01 Typical High $1,122.02 | Professional | None | $660.69 | $912.01 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $10,000.00 | Facility | None | $660.69 | $1,412.54 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $2,238.72 | Professional | None | $758.58 | $891.25 | $2,238.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $977.24 | Professional | None | $660.69 | $812.83 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $2,041.74 | Professional | None | $724.44 | $912.01 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,309.57 | Professional | None | $6,025.60 | $6,025.60 | $6,309.57 |
Molina Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $151,356.12 Typical High $251,188.64 | Facility | None | $831.76 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $2,238.72 | Professional | None | $758.58 | $870.96 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $645.65 Median $870.96 Typical High $2,454.71 | Professional | None | $645.65 | $870.96 | $2,454.71 |
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 $363.08 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $524.81 Typical High $1,202.26 | Professional | 62 · Two surgeons | $407.38 | $524.81 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $131.83 Typical High $309.03 | Professional | 80 · Assistant surgeon | $104.71 | $131.83 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $114.82 Typical High $269.15 | Professional | AS · PA/NP assist | $91.20 | $114.82 | $269.15 |
Where California sits
The same service costs 6.3 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· 27th of 51
$1,096
AK $3,388UT $537
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.