How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,175 to $12,589Professionalmedian $1,549 · 10th to 90th $1,122 to $5,370
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 $2,137.96 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,137.96 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,174.90 | $1,258.93 | $1,412.54 |
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 $1,380.38 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,380.38 | $1,819.70 | $3,548.13 |
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 $1,949.84 | Professional | None | $954.99 | $1,412.54 | $1,949.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,548.82 | $1,548.82 |
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 $1,258.93 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,445.44 | $2,187.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $1,737.80 | Professional | None | $794.33 | $1,380.38 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $3,715.35 | Professional | None | $1,174.90 | $1,479.11 | $3,715.35 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,258.93 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,412.54 | $2,137.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $1,071.52 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,348.96 | $2,238.72 |
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 $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,348.96 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $213.80 Typical High $338.84 | Professional | 80 · Assistant surgeon | $165.96 | $213.80 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $295.12 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $295.12 |
Where California sits
The same service costs 7.2 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· 29th of 51
$1,778
AK $5,495TX $759
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.