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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $177.83 | Professional | None | $147.91 | $154.88 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,137.96 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $870.96 | Professional | None | $501.19 | $524.81 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $2,570.40 Typical High $9,332.54 | Facility | None | $69.18 | $2,570.40 | $9,332.54 |
Blue Shield Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $537.03 | Professional | None | $275.42 | $389.05 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $489.78 | Professional | None | $239.88 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $758.58 Typical High $1,659.59 | Facility | None | $537.03 | $758.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,548.82 | Professional | None | $446.68 | $446.68 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $562.34 | Professional | None | $245.47 | $380.19 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,290.87 | $2,818.38 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $794.33 Typical High $3,630.78 | Facility | None | $478.63 | $794.33 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $645.65 | Professional | None | $194.98 | $204.17 | $645.65 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $741.31 | Professional | None | $147.91 | $269.15 | $741.31 |
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 $74.13 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $30.20 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 54 · Surgery only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $17.78 |
Where California sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 9th of 51
$525
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.