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 $218.78 Median $218.78 Typical High $5,370.32 | Professional | None | $218.78 | $218.78 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,606.93 Typical High $13,489.63 | Facility | None | $3,630.78 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $446.68 | Professional | None | $223.87 | $234.42 | $446.68 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $4,786.30 Typical High $12,022.64 | Facility | None | $69.18 | $4,786.30 | $12,022.64 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,162.28 Typical High $5,623.41 | Facility | None | $758.58 | $3,162.28 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $338.84 | Professional | None | $269.15 | $269.15 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,778.28 | $1,778.28 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $3,090.30 Typical High $5,623.41 | Facility | None | $660.69 | $3,090.30 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | None | $257.04 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $794.33 | Professional | None | $186.21 | $281.84 | $794.33 |
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 $100.00 Median $109.65 Typical High $114.82 | Professional | 52 · Reduced service | $100.00 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $43.65 Typical High $45.71 | Professional | 53 · Discontinued | $39.81 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 54 · Surgery only | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.11 Typical High $34.67 | Professional | 55 · Aftercare only | $30.20 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.88 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.95 | $21.88 | $22.91 |
Where California sits
The same service costs 10.7 times more in Colorado than in Maine. 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· 7th 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.