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 $81.28 Median $83.18 Typical High $91.20 | Facility | None | $81.28 | $83.18 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $91.20 | Professional | None | $75.86 | $81.28 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $89.13 | Professional | None | $63.10 | $77.62 | $89.13 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $1,000.00 Typical High $2,041.74 | Facility | None | $67.61 | $1,000.00 | $2,041.74 |
Blue Shield Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $97.72 | Professional | None | $63.10 | $89.13 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $2,630.27 | Facility | None | $489.78 | $562.34 | $2,630.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,174.90 | $1,174.90 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $151.36 | Professional | None | $81.28 | $89.13 | $151.36 |
Lucent Health Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $741.31 | Professional | None | $457.09 | $741.31 | $741.31 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $562.34 | Facility | None | $81.28 | $120.23 | $562.34 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,890.45 | Facility | None | $2,570.40 | $2,570.40 | $3,890.45 |
United Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $138.04 | Professional | None | $67.61 | $83.18 | $138.04 |
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 $38.02 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $15.14 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $8.13 | $9.12 |
Where California sits
The same service costs 3.2 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· 32nd of 51
$85.11
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.