How much rates vary
Facilitymedian $4,677 · 10th to 90th $661 to $33,113Professionalmedian $1,995 · 10th to 90th $1,585 to $8,511
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 $8,128.31 Typical High $19,054.61 | Facility | None | $1,862.09 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,778.28 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $12,589.25 Typical High $26,302.68 | Facility | None | $7,244.36 | $12,589.25 | $26,302.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $7,244.36 | Professional | None | $1,778.28 | $1,905.46 | $7,244.36 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,995.26 Typical High $14,454.40 | Facility | None | $95.50 | $1,995.26 | $14,454.40 |
Blue Shield Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $4,897.79 | Professional | None | $1,412.54 | $2,041.74 | $4,897.79 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,905.46 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,348.96 Typical High $10,000.00 | Facility | None | $660.69 | $1,348.96 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,897.79 | Professional | None | $1,698.24 | $1,949.84 | $4,897.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,905.46 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,513.56 | $1,905.46 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Professional | None | $14,791.08 | $14,791.08 | $14,791.08 |
Molina Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $151,356.12 Typical High $251,188.64 | Facility | None | $812.83 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,786.30 | Professional | None | $1,698.24 | $1,949.84 | $4,786.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
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 $1,380.38 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,380.38 | $1,862.09 | $5,128.61 |
10 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 $794.33 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $794.33 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $239.88 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,691.53 Typical High $6,165.95 | Professional | 50 · Both sides | $2,137.96 | $2,691.53 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,148.15 Typical High $2,630.27 | Professional | 62 · Two surgeons | $891.25 | $1,148.15 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $288.40 Typical High $660.69 | Professional | 80 · Assistant surgeon | $229.09 | $288.40 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $251.19 Typical High $575.44 | Professional | AS · PA/NP assist | $199.53 | $251.19 | $575.44 |
Where California sits
The same service costs 21.9 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· 33rd of 51
$2,042
AK $7,079TX $324
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.