How much rates vary
Facilitymedian $5,623 · 10th to 90th $631 to $50,119Professionalmedian $1,622 · 10th to 90th $1,175 to $10,233
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 $1,318.26 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,318.26 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,513.56 | Professional | None | $1,174.90 | $1,318.26 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $12,302.69 Typical High $24,547.09 | Facility | None | $7,413.10 | $12,302.69 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $5,370.32 | Professional | None | $1,584.89 | $1,698.24 | $5,370.32 |
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 $1,047.13 Median $1,513.56 Typical High $3,715.35 | Professional | None | $1,047.13 | $1,513.56 | $3,715.35 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,621.81 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,715.35 | Professional | None | $1,318.26 | $1,445.44 | $3,715.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,445.44 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,318.26 | $1,659.59 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $11,481.54 | Professional | None | $10,232.93 | $10,232.93 | $11,481.54 |
Molina Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,445.44 | $3,801.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
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 $1,096.48 Median $1,479.11 Typical High $4,073.80 | Professional | None | $1,096.48 | $1,479.11 | $4,073.80 |
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 $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $912.01 Typical High $2,137.96 | Professional | 62 · Two surgeons | $724.44 | $912.01 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $549.54 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $478.63 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $478.63 |
Where California sits
The same service costs 7.1 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· 25th of 51
$1,778
AK $5,754TX $813
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.