How much rates vary
Facilitymedian $4,898 · 10th to 90th $977 to $13,804Professionalmedian $1,230 · 10th to 90th $871 to $7,586
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 $1,862.09 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,862.09 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,513.56 | Professional | None | $912.01 | $1,047.13 | $1,513.56 |
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 $1,047.13 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,412.54 | $2,754.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $7,943.28 | Facility | None | $100.00 | $2,754.23 | $7,943.28 |
Blue Shield Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,479.11 | Professional | None | $724.44 | $1,071.52 | $1,479.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | None | $870.96 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $9,120.11 Typical High $16,218.10 | Facility | None | $575.44 | $9,120.11 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,659.59 | Professional | None | $977.24 | $1,071.52 | $1,659.59 |
Contra Costa Health Setting Professional Modifier None Typical Low $602.56 Median $1,071.52 Typical High $1,348.96 | Professional | None | $602.56 | $1,071.52 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,754.23 | Professional | None | $891.25 | $1,148.15 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,317.64 | Professional | None | $7,585.78 | $7,585.78 | $8,317.64 |
Molina Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $724.44 Median $7,413.10 Typical High $14,454.40 | Facility | None | $724.44 | $7,413.10 | $14,454.40 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,621.81 | Professional | None | $977.24 | $1,071.52 | $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 $2,290.87 Median $5,754.40 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,754.40 | $17,378.01 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,698.24 | Professional | None | $812.83 | $1,023.29 | $1,698.24 |
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 $457.09 Median $478.63 Typical High $524.81 | Professional | 52 · Reduced service | $457.09 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $208.93 | Professional | 53 · Discontinued | $181.97 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $104.71 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $645.65 Typical High $1,047.13 | Professional | 62 · Two surgeons | $501.19 | $645.65 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $162.18 Typical High $263.03 | Professional | 80 · Assistant surgeon | $125.89 | $162.18 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $141.25 Typical High $229.09 | Professional | AS · PA/NP assist | $109.65 | $141.25 | $229.09 |
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· 27th of 51
$1,380
AK $4,266UT $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.