How much rates vary
Facilitymedian $9,333 · 10th to 90th $1,549 to $53,703Professionalmedian $1,514 · 10th to 90th $1,047 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 $1,071.52 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,071.52 | $1,148.15 |
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 $1,348.96 Median $1,548.82 Typical High $3,630.78 | Professional | None | $1,348.96 | $1,548.82 | $3,630.78 |
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 $933.25 Median $1,380.38 Typical High $1,862.09 | Professional | None | $933.25 | $1,380.38 | $1,862.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,570.40 Typical High $16,595.87 | Facility | None | $676.08 | $2,570.40 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,380.38 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,479.11 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,621.81 | $3,801.89 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $12,302.69 | Professional | None | $9,549.93 | $9,549.93 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $1,412.54 Median $15,135.61 Typical High $251,188.64 | Facility | None | $1,412.54 | $15,135.61 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,380.38 | $2,041.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,332.54 Typical High $30,199.52 | Facility | None | $4,265.80 | $9,332.54 | $30,199.52 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,318.26 | $2,137.96 |
10 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 $537.03 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $107.15 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,818.38 Typical High $3,467.37 | Professional | 50 · Both sides | $2,041.74 | $2,818.38 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,174.90 Typical High $1,445.44 | Professional | 62 · Two surgeons | $870.96 | $1,174.90 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $295.12 Typical High $371.54 | Professional | 80 · Assistant surgeon | $218.78 | $295.12 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $263.03 Typical High $323.59 | Professional | AS · PA/NP assist | $190.55 | $263.03 | $323.59 |
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· 37th of 51
$1,549
AK $5,754TX $977
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.