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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,412.54 | $2,398.83 |
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 $33.88 Median $70.79 Typical High $2,290.87 | Professional | None | $33.88 | $70.79 | $2,290.87 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $2,187.76 Typical High $5,370.32 | Facility | None | $97.72 | $2,187.76 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,265.80 Typical High $6,760.83 | Facility | None | $758.58 | $4,265.80 | $6,760.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,454.71 | Professional | None | $691.83 | $1,584.89 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $8,912.51 Median $12,882.50 Typical High $12,882.50 | Professional | None | $8,912.51 | $12,882.50 | $12,882.50 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $10,232.93 | Facility | None | $851.14 | $4,365.16 | $10,232.93 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $741.31 | Professional | None | $707.95 | $724.44 | $741.31 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $6,025.60 | Professional | None | $1,258.93 | $1,778.28 | $6,025.60 |
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 $660.69 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $660.69 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $154.88 |
Where California sits
The same service costs 147.9 times more in Alaska 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· 6th of 51
$3,090
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.