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 $2,398.83 Median $9,120.11 Typical High $21,379.62 | Facility | None | $2,398.83 | $9,120.11 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $6,165.95 | Professional | None | $323.59 | $338.84 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $6,918.31 Typical High $15,135.61 | Facility | None | $3,715.35 | $6,918.31 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $707.95 | Professional | None | $239.88 | $398.11 | $707.95 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $977.24 Typical High $5,128.61 | Facility | None | $97.72 | $977.24 | $5,128.61 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $26,915.35 Typical High $47,863.01 | Facility | None | $758.58 | $26,915.35 | $47,863.01 |
Contra Costa Health Setting Professional Modifier None Typical Low $28,183.83 Median $28,183.83 Typical High $28,183.83 | Professional | None | $28,183.83 | $28,183.83 | $28,183.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $645.65 | Professional | None | $331.13 | $380.19 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,951.21 | Professional | None | $2,630.27 | $2,630.27 | $2,951.21 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $26,302.68 Typical High $45,708.82 | Facility | None | $630.96 | $26,302.68 | $45,708.82 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $371.54 | Professional | None | $346.74 | $363.08 | $371.54 |
United Setting Facility Modifier None Typical Low $12,022.64 Median $23,988.33 Typical High $56,234.13 | Facility | None | $12,022.64 | $23,988.33 | $56,234.13 |
United Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $1,258.93 | Professional | None | $295.12 | $436.52 | $1,258.93 |
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 $154.88 Median $165.96 Typical High $173.78 | Professional | 52 · Reduced service | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $61.66 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $234.42 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $52.48 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $35.48 |
Where California sits
The same service costs 63.1 times more in Arkansas than in New York. 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· 18th of 51
$2,630
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.