How much rates vary
Facilitymedian $6,457 · 10th to 90th $631 to $61,660Professionalmedian $2,399 · 10th to 90th $1,514 to $15,849
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 $1,659.59 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,659.59 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,548.82 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $13,803.84 Typical High $28,840.32 | Facility | None | $7,943.28 | $13,803.84 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $6,918.31 | Professional | None | $2,238.72 | $2,511.89 | $6,918.31 |
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 $4,466.84 | Professional | None | $1,258.93 | $1,778.28 | $4,466.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,584.89 | $2,187.76 | $2,398.83 |
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 $1,513.56 Median $1,905.46 Typical High $4,786.30 | Professional | None | $1,513.56 | $1,905.46 | $4,786.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,995.26 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $4,677.35 | Professional | None | $1,778.28 | $2,238.72 | $4,677.35 |
Lucent Health Setting Professional Modifier None Typical Low $15,848.93 Median $15,848.93 Typical High $16,595.87 | Professional | None | $15,848.93 | $15,848.93 | $16,595.87 |
Molina Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $1,513.56 Median $1,862.09 Typical High $5,011.87 | Professional | None | $1,513.56 | $1,862.09 | $5,011.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
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 $1,479.11 Median $1,949.84 Typical High $5,754.40 | Professional | None | $1,479.11 | $1,949.84 | $5,754.40 |
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 $724.44 Median $776.25 Typical High $831.76 | Professional | 52 · Reduced service | $724.44 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,096.48 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,230.27 Typical High $3,019.95 | Professional | 62 · Two surgeons | $977.24 | $1,230.27 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $316.23 Typical High $758.58 | Professional | 80 · Assistant surgeon | $245.47 | $316.23 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $275.42 Typical High $676.08 | Professional | AS · PA/NP assist | $218.78 | $275.42 | $676.08 |
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· 24th of 51
$2,399
AK $7,762TX $1,318
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.