How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,175 to $12,589Professionalmedian $1,622 · 10th to 90th $1,202 to $5,623
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 $1,288.25 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,380.38 | $1,445.44 |
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 $1,513.56 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,995.26 | $3,890.45 |
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 $954.99 Median $1,412.54 Typical High $1,995.26 | Professional | None | $954.99 | $1,412.54 | $1,995.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,621.81 | $1,659.59 |
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 $1,318.26 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,584.89 | $2,290.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,778.28 | Professional | None | $870.96 | $1,445.44 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $3,801.89 | Professional | None | $1,202.26 | $1,548.82 | $3,801.89 |
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $9,549.93 | Facility | None | $758.58 | $5,370.32 | $9,549.93 |
Providence Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,584.89 | $2,238.72 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 $1,122.02 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,412.54 | $2,344.23 |
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 $645.65 Median $676.08 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $870.96 Typical High $1,380.38 | Professional | 62 · Two surgeons | $676.08 | $870.96 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $223.87 Typical High $354.81 | Professional | 80 · Assistant surgeon | $173.78 | $223.87 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $309.03 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $309.03 |
Where California sits
The same service costs 24.5 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· 30th of 51
$1,820
AK $5,754TX $234
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.