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 $1,862.09 Median $8,128.31 Typical High $19,054.61 | Facility | None | $1,862.09 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $11,748.98 Typical High $20,417.38 | Facility | None | $5,888.44 | $11,748.98 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $1,096.48 | Professional | None | $575.44 | $602.56 | $1,096.48 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $79.43 Typical High $100.00 | Facility | None | $48.98 | $79.43 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,318.26 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $10,000.00 | Facility | None | $660.69 | $1,258.93 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,148.15 Typical High $2,238.72 | Professional | None | $436.52 | $1,148.15 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $4,897.79 Typical High $16,982.44 | Professional | None | $407.38 | $4,897.79 | $16,982.44 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
Molina Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $151,356.12 Typical High $251,188.64 | Facility | None | $794.33 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $436.52 | Professional | None | $79.43 | $79.43 | $436.52 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $11,748.98 | Facility | None | $524.81 | $1,380.38 | $11,748.98 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Where California sits
The same service costs 158.5 times more in Colorado than in Hawaii. 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· 41st of 51
$1,318
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.