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 $79.43 Median $81.28 Typical High $87.10 | Facility | None | $79.43 | $81.28 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $87.10 | Professional | None | $74.13 | $79.43 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $302.00 Typical High $1,258.93 | Facility | None | $239.88 | $302.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $281.84 | Professional | None | $199.53 | $245.47 | $281.84 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $933.25 Typical High $1,949.84 | Facility | None | $64.57 | $933.25 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $407.38 Typical High $407.38 | Professional | None | $134.90 | $407.38 | $407.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $724.44 | Professional | None | $512.86 | $724.44 | $724.44 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $134.90 | Facility | None | $79.43 | $114.82 | $134.90 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $407.38 Typical High $407.38 | Professional | None | $91.20 | $407.38 | $407.38 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $6,165.95 Typical High $18,620.87 | Facility | None | $1,995.26 | $6,165.95 | $18,620.87 |
United Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $147.91 | Professional | None | $63.10 | $79.43 | $147.91 |
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 $37.15 Median $39.81 Typical High $43.65 | Professional | 52 · Reduced service | $37.15 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $17.38 | Professional | 53 · Discontinued | $14.79 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.02 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.02 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $8.71 |
Where California sits
The same service costs 12.6 times more in California 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· 1st of 51
$245
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.