How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,023 to $10,000Professionalmedian $1,413 · 10th to 90th $955 to $8,511
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | None | $1,047.13 | $1,122.02 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,951.21 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,584.89 | $3,235.94 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $7,413.10 | Facility | None | $100.00 | $2,754.23 | $7,413.10 |
Blue Shield Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,737.80 | Professional | None | $851.14 | $1,258.93 | $1,737.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,318.26 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,479.11 Typical High $2,951.21 | Facility | None | $575.44 | $1,479.11 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,202.26 | $1,862.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,445.44 | Professional | None | $954.99 | $1,202.26 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $3,162.28 | Professional | None | $1,000.00 | $1,288.25 | $3,162.28 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $9,332.54 | Professional | None | $8,511.38 | $8,511.38 | $9,332.54 |
Molina Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $616.60 Median $1,584.89 Typical High $4,466.84 | Facility | None | $616.60 | $1,584.89 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,202.26 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,168.69 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,168.69 | $14,454.40 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,905.46 | Professional | None | $912.01 | $1,148.15 | $1,905.46 |
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 $524.81 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $851.14 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,819.70 Typical High $2,754.23 | Professional | 50 · Both sides | $1,445.44 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,148.15 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $295.12 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $169.82 Typical High $257.04 | Professional | AS · PA/NP assist | $134.90 | $169.82 | $257.04 |
Where California sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 25th of 51
$1,585
AK $4,786UT $776
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.