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 $457.09 Typical High $478.63 | Professional | None | $446.68 | $457.09 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $11,748.98 Typical High $20,892.96 | Facility | None | $6,456.54 | $11,748.98 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,479.11 | Professional | None | $870.96 | $891.25 | $1,479.11 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,819.70 Typical High $5,623.41 | Facility | None | $91.20 | $1,819.70 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $6,918.31 Typical High $12,302.69 | Facility | None | $758.58 | $6,918.31 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Contra Costa Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,079.46 | Professional | None | $6,760.83 | $6,760.83 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $630.96 Typical High $831.76 | Professional | None | $141.25 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,466.84 | Professional | None | $3,630.78 | $3,630.78 | $4,466.84 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $6,760.83 Typical High $12,022.64 | Facility | None | $691.83 | $6,760.83 | $12,022.64 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $2,454.71 | Professional | None | $537.03 | $549.54 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $11,481.54 | Facility | None | $1,258.93 | $3,090.30 | $11,481.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $831.76 | Professional | None | $389.05 | $489.78 | $831.76 |
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 $229.09 Typical High $239.88 | Professional | 52 · Reduced service | $223.87 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $331.13 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $47.86 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $47.86 |
Where California sits
The same service costs 7.2 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· 15th of 51
$912
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.