How much rates vary
Facilitymedian $3,802 · 10th to 90th $661 to $28,840Professionalmedian $1,413 · 10th to 90th $1,000 to $4,898
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 $1,174.90 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,174.90 | $8,128.31 | $19,054.61 |
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 $6,165.95 Median $11,481.54 Typical High $24,547.09 | Facility | None | $6,165.95 | $11,481.54 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,584.89 | $3,235.94 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $2,630.27 Typical High $5,888.44 | Facility | None | $95.50 | $2,630.27 | $5,888.44 |
Blue Shield Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,778.28 | Professional | None | $870.96 | $1,288.25 | $1,778.28 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,479.11 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,230.27 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $1,584.89 | Professional | None | $977.24 | $1,318.26 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,380.38 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $831.76 Median $151,356.12 Typical High $251,188.64 | Facility | None | $831.76 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,230.27 | $1,995.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
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 $954.99 Median $1,202.26 Typical High $2,137.96 | Professional | None | $954.99 | $1,202.26 | $2,137.96 |
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 $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 $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 $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $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 $660.69 Median $831.76 Typical High $1,230.27 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $208.93 Typical High $309.03 | Professional | 80 · Assistant surgeon | $165.96 | $208.93 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $269.15 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $269.15 |
Where California sits
The same service costs 6.5 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· 31st of 51
$1,479
AK $5,012TX $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.