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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | None | $295.12 | $309.03 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $6,918.31 Typical High $11,220.18 | Facility | None | $5,370.32 | $6,918.31 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $371.54 Typical High $645.65 | Professional | None | $354.81 | $371.54 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $28,840.32 Typical High $34,673.69 | Facility | None | $1,000.00 | $28,840.32 | $34,673.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $407.38 | Professional | None | $141.25 | $141.25 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,818.38 | $2,818.38 |
Providence Setting Facility Modifier None Typical Low $151,356.12 Median $151,356.12 Typical High $251,188.64 | Facility | None | $151,356.12 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | None | $331.13 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $1,258.93 | Professional | None | $263.03 | $363.08 | $1,258.93 |
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 $141.25 Median $154.88 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $61.66 Typical High $64.57 | Professional | 53 · Discontinued | $57.54 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $213.80 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $46.77 Typical High $48.98 | Professional | 55 · Aftercare only | $42.66 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.90 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.84 | $30.90 | $32.36 |
Where California sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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· 25th of 51
$468
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.