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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $1,584.89 | Professional | None | $125.89 | $125.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $2,511.89 | $4,897.79 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $3,981.07 | Professional | None | $117.49 | $181.97 | $3,981.07 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,174.90 Typical High $2,290.87 | Facility | None | $91.20 | $1,174.90 | $2,290.87 |
Blue Shield Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $245.47 | Professional | None | $61.66 | $114.82 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $630.96 Typical High $2,187.76 | Facility | None | $416.87 | $630.96 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $35.48 | Professional | None | $28.18 | $28.18 | $35.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $128.82 Median $446.68 Typical High $3,388.44 | Professional | None | $128.82 | $446.68 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $117.49 Median $354.81 Typical High $4,265.80 | Professional | None | $117.49 | $354.81 | $4,265.80 |
Lucent Health Setting Professional Modifier None Typical Low $10,471.29 Median $17,378.01 Typical High $17,378.01 | Professional | None | $10,471.29 | $17,378.01 | $17,378.01 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $4,897.79 | Facility | None | $380.19 | $707.95 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $263.03 | Professional | None | $112.20 | $117.49 | $263.03 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $4,677.35 | Facility | None | $398.11 | $1,202.26 | $4,677.35 |
United Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $724.44 | Professional | None | $114.82 | $169.82 | $724.44 |
4 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 $61.66 Median $63.10 Typical High $66.07 | Professional | 52 · Reduced service | $61.66 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.12 Typical High $26.92 | Professional | 53 · Discontinued | $24.55 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $19.95 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.59 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.30 | $12.59 | $13.18 |
Where California sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 11th of 51
$437
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.