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 $446.68 Median $489.78 Typical High $524.81 | Professional | None | $446.68 | $489.78 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,918.31 Typical High $13,489.63 | Facility | None | $3,630.78 | $6,918.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $977.24 Typical High $1,258.93 | Professional | None | $371.54 | $977.24 | $1,258.93 |
Blue Shield Setting Facility Modifier None Typical Low $89.13 Median $977.24 Typical High $4,786.30 | Facility | None | $89.13 | $977.24 | $4,786.30 |
Blue Shield Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $363.08 | Professional | None | $194.98 | $275.42 | $363.08 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $346.74 | Professional | None | $234.42 | $288.40 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,148.15 Typical High $5,623.41 | Facility | None | $660.69 | $1,148.15 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $501.19 | Professional | None | $218.78 | $275.42 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,398.83 | $2,951.21 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $870.96 Typical High $5,623.41 | Facility | None | $323.59 | $870.96 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $457.09 | Professional | None | $229.09 | $239.88 | $457.09 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,495.41 Typical High $17,378.01 | Facility | None | $2,290.87 | $5,495.41 | $17,378.01 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $524.81 | Professional | None | $218.78 | $281.84 | $524.81 |
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 $223.87 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $223.87 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $331.13 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $51.29 |
Where California sits
The same service costs 7.8 times more in Texas than in Delaware. 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· 27th of 51
$631
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.