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 $2,570.40 Median $8,912.51 Typical High $19,054.61 | Facility | None | $2,570.40 | $8,912.51 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,445.44 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $10,715.19 Typical High $19,054.61 | Facility | None | $6,165.95 | $10,715.19 | $19,054.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $4,786.30 | Professional | None | $1,548.82 | $2,041.74 | $4,786.30 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,737.80 Typical High $4,265.80 | Facility | None | $91.20 | $1,737.80 | $4,265.80 |
Blue Shield Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,454.71 | Professional | None | $891.25 | $1,288.25 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $10,232.93 Typical High $18,620.87 | Facility | None | $758.58 | $10,232.93 | $18,620.87 |
Contra Costa Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,380.38 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $10,715.19 Median $11,481.54 Typical High $11,481.54 | Professional | None | $10,715.19 | $11,481.54 | $11,481.54 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $10,000.00 Typical High $18,197.01 | Facility | None | $812.83 | $10,000.00 | $18,197.01 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,288.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $19,054.61 | Facility | None | $2,884.03 | $6,760.83 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $5,754.40 | Professional | None | $1,202.26 | $1,698.24 | $5,754.40 |
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 $660.69 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $151.36 |
Where California sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 24th of 51
$2,630
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.