How much rates vary
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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $11,481.54 Typical High $20,892.96 | Facility | None | $6,165.95 | $11,481.54 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $5,370.32 Typical High $7,079.46 | Professional | None | $1,348.96 | $5,370.32 | $7,079.46 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $2,754.23 Typical High $11,220.18 | Facility | None | $91.20 | $2,754.23 | $11,220.18 |
Blue Shield Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $776.25 | Professional | None | $416.87 | $602.56 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $16,982.44 Typical High $30,199.52 | Facility | None | $776.25 | $16,982.44 | $30,199.52 |
Contra Costa Health Setting Professional Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $17,378.01 | Professional | None | $16,595.87 | $16,595.87 | $17,378.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,737.80 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $12,589.25 | Professional | None | $10,232.93 | $10,232.93 | $12,589.25 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $14,791.08 Typical High $28,183.83 | Facility | None | $891.25 | $14,791.08 | $28,183.83 |
Providence Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $16,595.87 Typical High $35,481.34 | Facility | None | $7,943.28 | $16,595.87 | $35,481.34 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,380.38 | $2,754.23 |
5 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 $524.81 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $213.80 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $104.71 |
Where California sits
The same service costs 6.9 times more in Arkansas than in Kentucky. 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· 14th of 51
$2,754
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.