How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,148 to $12,589Professionalmedian $1,549 · 10th to 90th $1,096 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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,174.90 | $1,230.27 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,168.69 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,737.80 | $3,388.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $2,754.23 Typical High $8,317.64 | Facility | None | $100.00 | $2,754.23 | $8,317.64 |
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 $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,025.60 Typical High $10,232.93 | Facility | None | $645.65 | $6,025.60 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,380.38 | $2,089.30 |
Contra Costa Health Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,659.59 | Professional | None | $776.25 | $1,318.26 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $3,548.13 | Professional | None | $1,122.02 | $1,445.44 | $3,548.13 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $10,232.93 | Professional | None | $9,549.93 | $9,549.93 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $758.58 Median $5,370.32 Typical High $9,772.37 | Facility | None | $758.58 | $5,370.32 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,348.96 | $2,041.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $1,047.13 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,288.25 | $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 $588.84 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $870.96 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $812.83 | $870.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $812.83 Typical High $1,288.25 | Professional | 62 · Two surgeons | $630.96 | $812.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $331.13 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $181.97 Typical High $288.40 | Professional | AS · PA/NP assist | $141.25 | $181.97 | $288.40 |
Where California sits
The same service costs 11.0 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· 27th of 51
$1,738
AK $5,370TX $490
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.