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 $3,890.45 Median $9,772.37 Typical High $21,379.62 | Facility | None | $3,890.45 | $9,772.37 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $9,549.93 | Professional | None | $1,202.26 | $1,258.93 | $9,549.93 |
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 $891.25 Median $1,412.54 Typical High $3,019.95 | Professional | None | $891.25 | $1,412.54 | $3,019.95 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,348.96 Typical High $3,162.28 | Facility | None | $97.72 | $1,348.96 | $3,162.28 |
Blue Shield Setting Professional Modifier None Typical Low $288.40 Median $1,479.11 Typical High $2,754.23 | Professional | None | $288.40 | $1,479.11 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $6,606.93 Typical High $12,589.25 | Facility | None | $794.33 | $6,606.93 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $2,398.83 | Professional | None | $323.59 | $407.38 | $2,398.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $1,348.96 Typical High $2,754.23 | Professional | None | $407.38 | $1,348.96 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $12,882.50 Median $12,882.50 Typical High $15,848.93 | Professional | None | $12,882.50 | $12,882.50 | $15,848.93 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $6,165.95 Typical High $11,481.54 | Facility | None | $707.95 | $6,165.95 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $3,235.94 | Professional | None | $371.54 | $398.11 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $5,370.32 | Professional | None | $1,071.52 | $1,621.81 | $5,370.32 |
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 $562.34 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $125.89 |
Where California sits
The same service costs 9.1 times more in Oklahoma 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· 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.