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 $323.59 Median $338.84 Typical High $5,370.32 | Professional | None | $323.59 | $338.84 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $11,748.98 Typical High $20,892.96 | Facility | None | $6,025.60 | $11,748.98 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $645.65 | Professional | None | $323.59 | $338.84 | $645.65 |
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 $7,244.36 Typical High $12,882.50 | Facility | None | $758.58 | $7,244.36 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | None | $977.24 | $977.24 | $1,202.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
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 $5,370.32 Median $5,370.32 Typical High $6,309.57 | Professional | None | $5,370.32 | $5,370.32 | $6,309.57 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $7,079.46 Typical High $12,589.25 | Facility | None | $691.83 | $7,079.46 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | None | $741.31 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $15,135.61 | Facility | None | $1,659.59 | $4,365.16 | $15,135.61 |
United Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $1,479.11 | Professional | None | $275.42 | $436.52 | $1,479.11 |
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 $162.18 Median $162.18 Typical High $251.19 | Professional | 52 · Reduced service | $162.18 | $162.18 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $100.00 | Professional | 53 · Discontinued | $64.57 | $64.57 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $371.54 | Professional | 54 · Surgery only | $245.47 | $245.47 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $50.12 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $50.12 |
Where California sits
The same service costs 14.8 times more in Texas 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· 9th of 51
$2,291
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.