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 $1,905.46 Median $6,165.95 Typical High $15,848.93 | Facility | None | $1,905.46 | $6,165.95 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,905.46 | Professional | None | $616.60 | $660.69 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $5,248.07 Typical High $10,471.29 | Facility | None | $2,511.89 | $5,248.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $173.78 Typical High $741.31 | Professional | None | $39.81 | $173.78 | $741.31 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $1,548.82 Typical High $3,801.89 | Facility | None | $97.72 | $1,548.82 | $3,801.89 |
Blue Shield Setting Professional Modifier None Typical Low $20.89 Median $37.15 Typical High $79.43 | Professional | None | $20.89 | $37.15 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $5,370.32 | Facility | None | $758.58 | $2,630.27 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $524.81 Typical High $3,019.95 | Professional | None | $213.80 | $524.81 | $3,019.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $50.12 Typical High $81.28 | Professional | None | $28.84 | $50.12 | $81.28 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,570.40 Typical High $5,248.07 | Facility | None | $630.96 | $2,570.40 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $3,019.95 | Professional | None | $79.43 | $457.09 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,090.30 Typical High $10,964.78 | Facility | None | $1,258.93 | $3,090.30 | $10,964.78 |
United Setting Professional Modifier None Typical Low $407.38 Median $707.95 Typical High $1,862.09 | Professional | None | $407.38 | $707.95 | $1,862.09 |
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 $309.03 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $67.61 |
Where California sits
The same service costs 53.7 times more in Alaska 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· 40th of 51
$676
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.