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 $7,585.78 Typical High $18,197.01 | Facility | None | $2,238.72 | $7,585.78 | $18,197.01 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $5,370.32 | Professional | None | $295.12 | $295.12 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $12,022.64 Typical High $20,892.96 | Facility | None | $6,456.54 | $12,022.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $954.99 | Professional | None | $436.52 | $457.09 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,513.56 Typical High $5,495.41 | Facility | None | $91.20 | $1,513.56 | $5,495.41 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | None | $478.63 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $10,471.29 Typical High $18,620.87 | Facility | None | $758.58 | $10,471.29 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $537.03 | Professional | None | $426.58 | $426.58 | $537.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $870.96 | Professional | None | $457.09 | $501.19 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,801.89 | Professional | None | $3,090.30 | $3,090.30 | $3,801.89 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $10,232.93 Typical High $18,197.01 | Facility | None | $630.96 | $10,232.93 | $18,197.01 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | None | $489.78 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $29,512.09 | Facility | None | $4,265.80 | $9,772.37 | $29,512.09 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $1,258.93 | Professional | None | $257.04 | $389.05 | $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 $134.90 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $134.90 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $53.70 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $204.17 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $36.31 |
Where California sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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· 18th of 51
$1,778
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.