How much rates vary
Facilitymedian $7,413 · 10th to 90th $631 to $61,660Professionalmedian $2,951 · 10th to 90th $1,905 to $16,218
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 $2,137.96 Median $8,128.31 Typical High $19,054.61 | Facility | None | $2,137.96 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,905.46 | $2,041.74 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,511.38 Median $14,454.40 Typical High $28,840.32 | Facility | None | $8,511.38 | $14,454.40 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $3,090.30 Typical High $8,709.64 | Professional | None | $2,884.03 | $3,090.30 | $8,709.64 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $5,888.44 Typical High $12,302.69 | Facility | None | $67.61 | $5,888.44 | $12,302.69 |
Blue Shield Setting Professional Modifier None Typical Low $1,698.24 Median $2,398.83 Typical High $5,888.44 | Professional | None | $1,698.24 | $2,398.83 | $5,888.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,570.40 | $2,691.53 |
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 $2,137.96 Median $2,398.83 Typical High $6,165.95 | Professional | None | $2,137.96 | $2,398.83 | $6,165.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,445.44 | $2,344.23 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $6,309.57 | Professional | None | $2,137.96 | $2,691.53 | $6,309.57 |
Lucent Health Setting Professional Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $19,952.62 | Professional | None | $16,218.10 | $16,218.10 | $19,952.62 |
Molina Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $2,137.96 Median $2,344.23 Typical High $6,165.95 | Professional | None | $2,137.96 | $2,344.23 | $6,165.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
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 $1,862.09 Median $2,454.71 Typical High $7,079.46 | Professional | None | $1,862.09 | $2,454.71 | $7,079.46 |
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 $954.99 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $309.03 Typical High $346.74 | Professional | 55 · Aftercare only | $288.40 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,513.56 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,202.26 | $1,513.56 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $389.05 Typical High $933.25 | Professional | 80 · Assistant surgeon | $302.00 | $389.05 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $338.84 Typical High $812.83 | Professional | AS · PA/NP assist | $269.15 | $338.84 | $812.83 |
Where California sits
The same service costs 7.6 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· 25th of 51
$2,951
AK $9,550TX $1,259
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.