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 $48.98 Median $660.69 Typical High $758.58 | Professional | None | $48.98 | $660.69 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,677.35 | $8,511.38 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $676.08 Typical High $1,071.52 | Professional | None | $194.98 | $676.08 | $1,071.52 |
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 $190.55 Median $489.78 Typical High $1,096.48 | Professional | None | $190.55 | $489.78 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $6,309.57 | Professional | None | $1,737.80 | $2,691.53 | $6,309.57 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,951.21 Typical High $5,888.44 | Facility | None | $707.95 | $2,951.21 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $588.84 | Professional | None | $60.26 | $79.43 | $588.84 |
Sutter Health Plus Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
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 $24.55 Median $24.55 Typical High $331.13 | Professional | 52 · Reduced service | $24.55 | $24.55 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $37.15 Typical High $489.78 | Professional | 54 · Surgery only | $37.15 | $37.15 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Where California sits
The same service costs 74.1 times more in Oklahoma 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· 31st of 51
$1,023
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.