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 $1,659.59 Median $1,819.70 Typical High $5,128.61 | Professional | None | $1,659.59 | $1,819.70 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,677.35 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $2,137.96 Typical High $3,630.78 | Professional | None | $169.82 | $2,137.96 | $3,630.78 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $398.11 Typical High $1,698.24 | Facility | None | $97.72 | $398.11 | $1,698.24 |
Blue Shield Setting Professional Modifier None Typical Low $1,621.81 Median $2,290.87 Typical High $3,890.45 | Professional | None | $1,621.81 | $2,290.87 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,235.94 Typical High $5,623.41 | Facility | None | $758.58 | $3,235.94 | $5,623.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $11,481.54 Median $11,481.54 Typical High $14,125.38 | Professional | None | $11,481.54 | $11,481.54 | $14,125.38 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $3,235.94 Typical High $5,623.41 | Facility | None | $812.83 | $3,235.94 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
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 $1,513.56 Median $2,290.87 Typical High $6,165.95 | Professional | None | $1,513.56 | $2,290.87 | $6,165.95 |
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 $831.76 Median $912.01 Typical High $954.99 | Professional | 52 · Reduced service | $831.76 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | 53 · Discontinued | $331.13 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $245.47 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $181.97 Typical High $190.55 | Professional | 56 · Pre-op care only | $165.96 | $181.97 | $190.55 |
Where California sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 32nd 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.