How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $13,490Professionalmedian $1,413 · 10th to 90th $955 to $7,943
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 $2,238.72 Median $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,071.52 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $10,232.93 Typical High $18,620.87 | Facility | None | $5,248.07 | $10,232.93 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,548.82 | $3,090.30 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,818.38 Typical High $9,549.93 | Facility | None | $100.00 | $2,818.38 | $9,549.93 |
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 $1,000.00 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,230.27 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,073.80 Typical High $7,762.47 | Facility | None | $758.58 | $4,073.80 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,174.90 | $1,819.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,479.11 | Professional | None | $831.76 | $1,096.48 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $2,951.21 | Professional | None | $912.01 | $1,148.15 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,128.31 | Professional | None | $7,943.28 | $7,943.28 | $8,128.31 |
Molina Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $812.83 Median $3,890.45 Typical High $7,762.47 | Facility | None | $812.83 | $3,890.45 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,174.90 | $1,778.28 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,623.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,623.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,778.28 | Professional | None | $851.14 | $1,122.02 | $1,778.28 |
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 $501.19 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $831.76 |
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 $177.83 Typical High $257.04 | Professional | 80 · Assistant surgeon | $144.54 | $177.83 | $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 6.3 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
$1,549
AK $4,365UT $692
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.