How much rates vary
Facilitymedian $6,310 · 10th to 90th $631 to $56,234Professionalmedian $1,862 · 10th to 90th $1,479 to $11,749
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 $1,659.59 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,659.59 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,445.44 | $1,584.89 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $11,481.54 Typical High $22,908.68 | Facility | None | $6,165.95 | $11,481.54 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $6,760.83 | Professional | None | $1,548.82 | $1,778.28 | $6,760.83 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $4,786.30 Typical High $10,000.00 | Facility | None | $67.61 | $4,786.30 | $10,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $4,466.84 | Professional | None | $1,288.25 | $1,862.09 | $4,466.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,862.09 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $10,000.00 | Facility | None | $660.69 | $1,445.44 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,584.89 | $1,819.70 | $4,570.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,258.93 | $1,659.59 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,445.44 | $1,819.70 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,302.69 | Professional | None | $11,748.98 | $11,748.98 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $151,356.12 Typical High $251,188.64 | Facility | None | $851.14 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $4,466.84 | Professional | None | $1,584.89 | $1,778.28 | $4,466.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Professional | None | $5,370.32 | $5,370.32 | $5,370.32 |
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 $1,288.25 Median $1,737.80 Typical High $4,786.30 | Professional | None | $1,288.25 | $1,737.80 | $4,786.30 |
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 $707.95 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $331.13 | Professional | 53 · Discontinued | $288.40 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,096.48 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,096.48 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,023.29 Typical High $2,454.71 | Professional | 62 · Two surgeons | $831.76 | $1,023.29 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $269.15 Typical High $616.60 | Professional | 80 · Assistant surgeon | $213.80 | $269.15 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $229.09 Typical High $537.03 | Professional | AS · PA/NP assist | $186.21 | $229.09 | $537.03 |
Where California sits
The same service costs 7.8 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· 28th of 51
$1,995
AK $6,607TX $851
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.