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 $2,818.38 Median $9,120.11 Typical High $19,498.45 | Facility | None | $2,818.38 | $9,120.11 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $6,025.60 | Professional | None | $691.83 | $758.58 | $6,025.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $16,982.44 Typical High $30,902.95 | Facility | None | $9,332.54 | $16,982.44 | $30,902.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $891.25 | Professional | None | $316.23 | $407.38 | $891.25 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,348.96 Typical High $3,162.28 | Facility | None | $91.20 | $1,348.96 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $28,840.32 Typical High $50,118.72 | Facility | None | $758.58 | $28,840.32 | $50,118.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $30,199.52 | Professional | None | $30,199.52 | $30,199.52 | $30,199.52 |
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 $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $28,183.83 Typical High $50,118.72 | Facility | None | $758.58 | $28,183.83 | $50,118.72 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $363.08 | Professional | None | $354.81 | $363.08 | $363.08 |
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 $645.65 Median $954.99 Typical High $2,454.71 | Professional | None | $645.65 | $954.99 | $2,454.71 |
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 $346.74 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $346.74 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $158.49 | Professional | 53 · Discontinued | $141.25 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $562.34 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $79.43 |
Where California sits
The same service costs 50.1 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· 12th of 51
$3,715
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.