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 $1,380.38 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,380.38 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $114.82 Typical High $7,943.28 | Professional | None | $107.15 | $114.82 | $7,943.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $13,489.63 Typical High $23,442.29 | Facility | None | $5,011.87 | $13,489.63 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $457.09 | Professional | None | $165.96 | $186.21 | $457.09 |
Blue Shield Setting Facility Modifier None Typical Low $69.18 Median $3,019.95 Typical High $6,456.54 | Facility | None | $69.18 | $3,019.95 | $6,456.54 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $389.05 | Professional | None | $89.13 | $141.25 | $389.05 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $165.96 | Professional | None | $97.72 | $131.83 | $165.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $323.59 | Professional | None | $97.72 | $128.82 | $323.59 |
Molina Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $151.36 Typical High $239.88 | Facility | None | $107.15 | $151.36 | $239.88 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $165.96 | Professional | None | $79.43 | $104.71 | $165.96 |
Sutter Health Plus Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $4,365.16 Typical High $10,000.00 | Facility | None | $2,398.83 | $4,365.16 | $10,000.00 |
United Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $575.44 | Professional | None | $102.33 | $165.96 | $575.44 |
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 $53.70 Median $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $21.38 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $81.28 Typical High $89.13 | Professional | 54 · Surgery only | $79.43 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $12.02 |
Where California sits
The same service costs 37.2 times more in Oklahoma than in New York. 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· 16th of 51
$398
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.