How much rates vary
Facilitymedian $6,761 · 10th to 90th $631 to $61,660Professionalmedian $2,570 · 10th to 90th $1,660 to $16,596
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 $1,862.09 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,862.09 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,778.28 | $2,187.76 |
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 $2,344.23 Median $2,691.53 Typical High $7,413.10 | Professional | None | $2,344.23 | $2,691.53 | $7,413.10 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,786.30 Typical High $10,000.00 | Facility | None | $67.61 | $4,786.30 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $5,011.87 | Professional | None | $1,445.44 | $2,089.30 | $5,011.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,778.28 | $2,290.87 | $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 $1,862.09 Median $2,089.30 Typical High $5,248.07 | Professional | None | $1,862.09 | $2,089.30 | $5,248.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,412.54 | $2,041.74 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $5,495.41 | Professional | None | $1,862.09 | $2,344.23 | $5,495.41 |
Lucent Health Setting Professional Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $17,378.01 | Professional | None | $16,595.87 | $16,595.87 | $17,378.01 |
Molina Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $1,862.09 Median $2,041.74 Typical High $5,370.32 | Professional | None | $1,862.09 | $2,041.74 | $5,370.32 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
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 $1,584.89 Median $2,137.96 Typical High $6,165.95 | Professional | None | $1,584.89 | $2,137.96 | $6,165.95 |
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 $831.76 Median $891.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $891.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,230.27 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,230.27 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,318.26 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,023.29 | $1,318.26 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $331.13 Typical High $812.83 | Professional | 80 · Assistant surgeon | $263.03 | $331.13 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $288.40 Typical High $707.95 | Professional | AS · PA/NP assist | $229.09 | $288.40 | $707.95 |
Where California sits
The same service costs 7.8 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· 26th of 51
$2,570
AK $8,128TX $1,047
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.