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 $2,238.72 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,238.72 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | None | $208.93 | $229.09 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $5,011.87 Typical High $10,000.00 | Facility | None | $2,511.89 | $5,011.87 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $67.61 Typical High $263.03 | Professional | None | $44.67 | $67.61 | $263.03 |
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 $630.96 Median $1,000.00 Typical High $2,691.53 | Facility | None | $630.96 | $1,000.00 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $407.38 | Professional | None | $128.82 | $134.90 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,288.25 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $851.14 Typical High $2,691.53 | Facility | None | $316.23 | $851.14 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | None | $169.82 | $177.83 | $177.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $436.52 | Professional | None | $177.83 | $229.09 | $436.52 |
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 $104.71 Median $114.82 Typical High $123.03 | Professional | 52 · Reduced service | $104.71 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $42.66 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $158.49 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.91 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.89 | $22.91 | $24.55 |
Where California sits
The same service costs 18.6 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· 7th of 51
$407
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.