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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $77.62 Typical High $1,819.70 | Professional | None | $72.44 | $77.62 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $10,232.93 Typical High $38,018.94 | Facility | None | $2,951.21 | $10,232.93 | $38,018.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $645.65 Typical High $3,715.35 | Professional | None | $173.78 | $645.65 | $3,715.35 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $2,570.40 Typical High $6,456.54 | Facility | None | $64.57 | $2,570.40 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,691.53 Typical High $23,988.33 | Facility | None | $676.08 | $2,691.53 | $23,988.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $75.86 | Professional | None | $39.81 | $45.71 | $75.86 |
Lucent Health Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Professional | None | $18,620.87 | $18,620.87 | $18,620.87 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $151,356.12 Typical High $251,188.64 | Facility | None | $630.96 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | None | $43.65 | $44.67 | $44.67 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
United Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $630.96 | Professional | None | $66.07 | $100.00 | $630.96 |
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 $36.31 Median $38.90 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $38.90 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.49 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $12.59 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $7.76 | $8.51 |
Where California sits
The same service costs 30.9 times more in California than in Idaho. 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
$3,236
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.