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 $2,137.96 Median $6,760.83 Typical High $16,218.10 | Facility | None | $2,137.96 | $6,760.83 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $426.58 | Professional | None | $371.54 | $371.54 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $6,606.93 Typical High $13,489.63 | Facility | None | $3,630.78 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $2,454.71 | Professional | None | $173.78 | $239.88 | $2,454.71 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,737.80 Typical High $8,128.31 | Facility | None | $100.00 | $1,737.80 | $8,128.31 |
Blue Shield Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $331.13 | Professional | None | $169.82 | $245.47 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,884.03 Typical High $4,786.30 | Facility | None | $645.65 | $2,884.03 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $7,079.46 | Professional | None | $316.23 | $524.81 | $7,079.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $5,370.32 | Professional | None | $1,659.59 | $2,290.87 | $5,370.32 |
Lucent Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $5,754.40 | Facility | None | $645.65 | $2,951.21 | $5,754.40 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $616.60 | Professional | None | $70.79 | $79.43 | $616.60 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $4,365.16 Typical High $14,454.40 | Facility | None | $1,659.59 | $4,365.16 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,412.54 | $1,737.80 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where California sits
The same service costs 64.6 times more in Wisconsin than in Montana. 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· 29th of 51
$1,047
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.