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 $3,311.31 Median $9,549.93 Typical High $19,054.61 | Facility | None | $3,311.31 | $9,549.93 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $10,964.78 | Professional | None | $46.77 | $48.98 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $16,982.44 | Facility | None | $4,786.30 | $8,912.51 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $389.05 Typical High $724.44 | Professional | None | $50.12 | $389.05 | $724.44 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $977.24 Typical High $5,248.07 | Facility | None | $97.72 | $977.24 | $5,248.07 |
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 $9,772.37 Typical High $17,782.79 | Facility | None | $758.58 | $9,772.37 | $17,782.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $10,232.93 | Professional | None | $10,232.93 | $10,232.93 | $10,232.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,691.53 | $2,691.53 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $9,772.37 Typical High $16,982.44 | Facility | None | $660.69 | $9,772.37 | $16,982.44 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $371.54 | Professional | None | $354.81 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $29,512.09 | Facility | None | $4,265.80 | $9,772.37 | $29,512.09 |
United Setting Professional Modifier None Typical Low $40.74 Median $64.57 Typical High $389.05 | Professional | None | $40.74 | $64.57 | $389.05 |
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 $23.44 Median $23.44 Typical High $30.90 | Professional | 52 · Reduced service | $23.44 | $23.44 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $12.30 | Professional | 53 · Discontinued | $9.33 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $34.67 Typical High $46.77 | Professional | 54 · Surgery only | $34.67 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $9.33 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $6.17 |
Where California sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 13th of 51
$3,020
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.