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 $446.68 Median $478.63 Typical High $5,370.32 | Professional | None | $446.68 | $478.63 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $12,302.69 Typical High $21,379.62 | Facility | None | $6,456.54 | $12,302.69 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $977.24 | Professional | None | $489.78 | $512.86 | $977.24 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $4,897.79 Typical High $23,988.33 | Facility | None | $69.18 | $4,897.79 | $23,988.33 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $10,964.78 Typical High $19,498.45 | Facility | None | $758.58 | $10,964.78 | $19,498.45 |
Contra Costa Health Setting Professional Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
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 $3,388.44 Median $3,388.44 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,388.44 | $3,801.89 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $10,715.19 Typical High $19,054.61 | Facility | None | $691.83 | $10,715.19 | $19,054.61 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | None | $457.09 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $12,022.64 Median $23,988.33 Typical High $56,234.13 | Facility | None | $12,022.64 | $23,988.33 | $56,234.13 |
United Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,737.80 | Professional | None | $416.87 | $602.56 | $1,737.80 |
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 $218.78 Median $239.88 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $87.10 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $50.12 |
Where California sits
The same service costs 24.0 times more in Arkansas than in New York. 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· 14th of 51
$3,388
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.