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 $380.19 Median $407.38 Typical High $4,466.84 | Professional | None | $380.19 | $407.38 | $4,466.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $16,982.44 | Facility | None | $4,466.84 | $8,317.64 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $676.08 | Professional | None | $229.09 | $389.05 | $676.08 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $1,071.52 Typical High $6,025.60 | Facility | None | $95.50 | $1,071.52 | $6,025.60 |
Blue Shield Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $630.96 | Professional | None | $263.03 | $380.19 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,819.70 Typical High $4,570.88 | Facility | None | $776.25 | $1,819.70 | $4,570.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $660.69 | Professional | None | $338.84 | $380.19 | $660.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,511.89 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $1,995.26 Typical High $7,585.78 | Facility | None | $676.08 | $1,995.26 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $602.56 | Professional | None | $346.74 | $380.19 | $602.56 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,621.81 Typical High $6,309.57 | Facility | None | $616.60 | $1,621.81 | $6,309.57 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,348.96 | Professional | None | $346.74 | $524.81 | $1,348.96 |
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 $190.55 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $309.03 Typical High $323.59 | Professional | 54 · Surgery only | $281.84 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $40.74 | $42.66 |
Where California sits
The same service costs 8.1 times more in Texas 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· 3rd of 51
$1,549
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.