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 $346.74 Median $371.54 Typical High $6,165.95 | Professional | None | $346.74 | $371.54 | $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 $245.47 Median $407.38 Typical High $741.31 | Professional | None | $245.47 | $407.38 | $741.31 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $4,168.69 Typical High $19,054.61 | Facility | None | $69.18 | $4,168.69 | $19,054.61 |
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 $25,703.96 Typical High $46,773.51 | Facility | None | $758.58 | $25,703.96 | $46,773.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $27,542.29 Median $27,542.29 Typical High $27,542.29 | Professional | None | $27,542.29 | $27,542.29 | $27,542.29 |
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 $2,630.27 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,630.27 | $2,630.27 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $25,703.96 Typical High $45,708.82 | Facility | None | $660.69 | $25,703.96 | $45,708.82 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | None | $354.81 | $363.08 | $363.08 |
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 $331.13 Median $478.63 Typical High $1,380.38 | Professional | None | $331.13 | $478.63 | $1,380.38 |
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 $173.78 Median $186.21 Typical High $194.98 | Professional | 52 · Reduced service | $173.78 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $77.62 | Professional | 53 · Discontinued | $69.18 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $295.12 | Professional | 54 · Surgery only | $257.04 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $58.88 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $38.90 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $38.90 |
Where California sits
The same service costs 57.5 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· 16th 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.