How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,122 to $18,621Professionalmedian $1,349 · 10th to 90th $977 to $5,370
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 $2,818.38 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,818.38 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $4,073.80 | Professional | None | $1,000.00 | $1,122.02 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $14,125.38 Typical High $26,302.68 | Facility | None | $7,244.36 | $14,125.38 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $4,466.84 | Professional | None | $1,318.26 | $1,479.11 | $4,466.84 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,621.81 Typical High $19,498.45 | Facility | None | $100.00 | $1,621.81 | $19,498.45 |
Blue Shield Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $3,019.95 | Professional | None | $912.01 | $1,288.25 | $3,019.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | None | $870.96 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $7,585.78 Typical High $13,182.57 | Facility | None | $851.14 | $7,585.78 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,230.27 | $3,090.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,288.25 | Professional | None | $707.95 | $1,071.52 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,884.03 | Professional | None | $954.99 | $1,230.27 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $7,079.46 Typical High $12,589.25 | Facility | None | $1,000.00 | $7,079.46 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,202.26 | $3,019.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $7,079.46 Typical High $19,054.61 | Facility | None | $2,884.03 | $7,079.46 | $19,054.61 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $3,311.31 | Professional | None | $891.25 | $1,174.90 | $3,311.31 |
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 $501.19 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $724.44 Typical High $1,698.24 | Professional | 62 · Two surgeons | $562.34 | $724.44 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $181.97 Typical High $426.58 | Professional | 80 · Assistant surgeon | $141.25 | $181.97 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $162.18 Typical High $371.54 | Professional | AS · PA/NP assist | $123.03 | $162.18 | $371.54 |
Where California sits
The same service costs 8.7 times more in Oklahoma 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· 33rd of 51
$1,514
OK $6,166TX $708
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.