How much rates vary
Facilitymedian $6,166 · 10th to 90th $631 to $54,954Professionalmedian $1,072 · 10th to 90th $741 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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $851.14 | Professional | None | $741.31 | $776.25 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $12,022.64 Typical High $24,547.09 | Facility | None | $6,760.83 | $12,022.64 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,071.52 | $2,570.40 |
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 $588.84 Median $870.96 Typical High $1,202.26 | Professional | None | $588.84 | $870.96 | $1,202.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,412.54 | Professional | None | $977.24 | $1,318.26 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,659.59 | Professional | None | $776.25 | $1,000.00 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,412.54 | Professional | None | $741.31 | $1,202.26 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,288.25 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,772.37 | Professional | None | $9,549.93 | $9,549.93 | $9,772.37 |
Molina Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $776.25 Median $151,356.12 Typical High $251,188.64 | Facility | None | $776.25 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,621.81 | Professional | None | $776.25 | $1,000.00 | $1,621.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $776.25 Median $1,000.00 Typical High $1,659.59 | Professional | None | $776.25 | $1,000.00 | $1,659.59 |
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 $371.54 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,698.24 Typical High $2,454.71 | Professional | 50 · Both sides | $1,348.96 | $1,698.24 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $707.95 Typical High $1,023.29 | Professional | 62 · Two surgeons | $562.34 | $707.95 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $181.97 Typical High $257.04 | Professional | 80 · Assistant surgeon | $144.54 | $181.97 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $158.49 Typical High $229.09 | Professional | AS · PA/NP assist | $125.89 | $158.49 | $229.09 |
Where California sits
The same service costs 21.9 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· 42nd of 51
$1,072
AK $4,467TX $204
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.