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 $10,000.00 Typical High $21,379.62 | Facility | None | $2,818.38 | $10,000.00 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $6,606.93 | Professional | None | $977.24 | $1,023.29 | $6,606.93 |
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 $338.84 Median $1,230.27 Typical High $2,137.96 | Professional | None | $338.84 | $1,230.27 | $2,137.96 |
Blue Shield Setting Facility Modifier None Typical Low $66.07 Median $954.99 Typical High $7,079.46 | Facility | None | $66.07 | $954.99 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,778.28 Typical High $12,302.69 | Facility | None | $660.69 | $1,778.28 | $12,302.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $16,982.44 Typical High $16,982.44 | Professional | None | $407.38 | $16,982.44 | $16,982.44 |
Lucent Health Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,772.37 | Professional | None | $7,943.28 | $7,943.28 | $9,772.37 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,445.44 Typical High $5,623.41 | Facility | None | $660.69 | $1,445.44 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,174.90 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $9,772.37 Typical High $30,199.52 | Facility | None | $4,265.80 | $9,772.37 | $30,199.52 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,348.96 Typical High $3,890.45 | Professional | None | $891.25 | $1,348.96 | $3,890.45 |
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 $467.74 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $107.15 |
Where California sits
The same service costs 18.2 times more in California 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· 1st of 51
$7,586
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.