How much rates vary
Facilitymedian $5,370 · 10th to 90th $631 to $50,119Professionalmedian $1,698 · 10th to 90th $1,148 to $10,000
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 $1,348.96 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,348.96 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,258.93 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,709.64 Typical High $18,197.01 | Facility | None | $5,011.87 | $8,709.64 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,348.96 | $1,819.70 | $3,467.37 |
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 $1,905.46 | Professional | None | $933.25 | $1,380.38 | $1,905.46 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,232.93 | Facility | None | $660.69 | $1,445.44 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,412.54 | $2,187.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $851.14 Median $1,548.82 Typical High $1,698.24 | Professional | None | $851.14 | $1,548.82 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,698.24 | $3,890.45 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $12,882.50 | Professional | None | $10,000.00 | $10,000.00 | $12,882.50 |
Molina Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $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 $1,230.27 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,412.54 | $2,137.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $1,122.02 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,380.38 | $2,187.76 |
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 $588.84 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $933.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $741.31 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $239.88 Typical High $398.11 | Professional | 80 · Assistant surgeon | $186.21 | $239.88 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $316.23 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $316.23 |
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· 26th of 51
$1,778
AK $5,888TX $1,000
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.