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 $87.10 | Facility | None | $81.28 | $83.18 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $87.10 | Professional | None | $75.86 | $81.28 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $128.82 | Professional | None | $75.86 | $87.10 | $128.82 |
Blue Shield Setting Facility Modifier None Typical Low $295.12 Median $758.58 Typical High $1,318.26 | Facility | None | $295.12 | $758.58 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $478.63 Typical High $1,380.38 | Facility | None | $426.58 | $478.63 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $831.76 | Professional | None | $407.38 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $851.14 | Professional | None | $524.81 | $524.81 | $851.14 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $186.21 Typical High $223.87 | Facility | None | $95.50 | $186.21 | $223.87 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $478.63 Typical High $478.63 | Professional | None | $109.65 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $870.96 | Facility | None | $562.34 | $562.34 | $870.96 |
United Setting Professional Modifier None Typical Low $69.18 Median $87.10 Typical High $199.53 | Professional | None | $69.18 | $87.10 | $199.53 |
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 $39.81 Typical High $43.65 | Professional | 52 · Reduced service | $38.02 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.22 Typical High $17.38 | Professional | 53 · Discontinued | $15.14 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $13.18 | Professional | 55 · Aftercare only | $11.22 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $8.71 |
Where California sits
The same service costs 5.0 times more in Alaska than in Pennsylvania. 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· 34th of 51
$91.20
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.