How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $61,660Professionalmedian $2,138 · 10th to 90th $1,413 to $14,125
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 $1,584.89 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,584.89 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $12,589.25 Typical High $27,542.29 | Facility | None | $7,079.46 | $12,589.25 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $6,309.57 | Professional | None | $2,041.74 | $2,238.72 | $6,309.57 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,168.69 Typical High $8,709.64 | Facility | None | $67.61 | $4,168.69 | $8,709.64 |
Blue Shield Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $4,365.16 | Professional | None | $1,258.93 | $1,778.28 | $4,365.16 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,819.70 | $1,995.26 |
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 $1,548.82 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,548.82 | $1,778.28 | $4,466.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,819.70 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $4,786.30 | Professional | None | $1,621.81 | $2,041.74 | $4,786.30 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $15,135.61 | Professional | None | $14,125.38 | $14,125.38 | $15,135.61 |
Molina Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
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 $1,548.82 Median $1,737.80 Typical High $4,466.84 | Professional | None | $1,548.82 | $1,737.80 | $4,466.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
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 $1,318.26 Median $1,778.28 Typical High $5,248.07 | Professional | None | $1,318.26 | $1,778.28 | $5,248.07 |
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 $707.95 Median $758.58 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $758.58 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,096.48 Typical High $2,691.53 | Professional | 62 · Two surgeons | $870.96 | $1,096.48 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $281.84 Typical High $676.08 | Professional | 80 · Assistant surgeon | $223.87 | $281.84 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $245.47 Typical High $602.56 | Professional | AS · PA/NP assist | $194.98 | $245.47 | $602.56 |
Where California sits
The same service costs 5.9 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
$2,188
AK $6,918TX $1,175
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.