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 $104.71 Median $109.65 Typical High $6,760.83 | Professional | None | $104.71 | $109.65 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,456.54 Typical High $13,489.63 | Facility | None | $3,630.78 | $6,456.54 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $218.78 | Professional | None | $97.72 | $147.91 | $218.78 |
Blue Shield Setting Facility Modifier None Typical Low $67.61 Median $1,202.26 Typical High $3,388.44 | Facility | None | $67.61 | $1,202.26 | $3,388.44 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $239.88 | Professional | None | $89.13 | $125.89 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $218.78 | Professional | None | $95.50 | $123.03 | $218.78 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $10,000.00 Typical High $19,952.62 | Facility | None | $141.25 | $10,000.00 | $19,952.62 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $100.00 | Professional | None | $93.33 | $95.50 | $100.00 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $7,413.10 Typical High $15,135.61 | Facility | None | $3,981.07 | $7,413.10 | $15,135.61 |
United Setting Professional Modifier None Typical Low $93.33 Median $147.91 Typical High $501.19 | Professional | None | $93.33 | $147.91 | $501.19 |
5 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 $52.48 Median $52.48 Typical High $57.54 | Professional | 52 · Reduced service | $52.48 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | 53 · Discontinued | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 54 · Surgery only | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $11.48 |
Where California sits
The same service costs 51.3 times more in Oklahoma than in Kentucky. 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· 36th of 51
$162
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.