How much rates vary
Facilitymedian $5,012 · 10th to 90th $661 to $61,660Professionalmedian $1,549 · 10th to 90th $1,023 to $9,550
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 $1,148.15 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,148.15 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,023.29 | $1,096.48 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $11,220.18 Typical High $23,988.33 | Facility | None | $5,011.87 | $11,220.18 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,659.59 | $4,466.84 |
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 $831.76 Median $1,174.90 Typical High $2,884.03 | Professional | None | $831.76 | $1,174.90 | $2,884.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,513.56 | $1,778.28 |
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 $1,122.02 Median $1,258.93 Typical High $3,162.28 | Professional | None | $1,122.02 | $1,258.93 | $3,162.28 |
Contra Costa Health Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $1,621.81 | Professional | None | $933.25 | $1,348.96 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $3,630.78 | Professional | None | $1,202.26 | $1,513.56 | $3,630.78 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $11,220.18 | Professional | None | $9,549.93 | $9,549.93 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,122.02 Median $1,258.93 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,258.93 | $3,311.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $3,801.89 | Professional | None | $954.99 | $1,288.25 | $3,801.89 |
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 $512.86 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $758.58 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $812.83 Typical High $1,949.84 | Professional | 62 · Two surgeons | $630.96 | $812.83 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $501.19 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $436.52 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $436.52 |
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· 24th of 51
$1,622
AK $5,012TX $891
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.