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 $1,698.24 Median $5,370.32 Typical High $15,848.93 | Facility | None | $1,698.24 | $5,370.32 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,698.24 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $4,786.30 Typical High $6,606.93 | Facility | None | $3,235.94 | $4,786.30 | $6,606.93 |
Blue Shield Setting Facility Modifier None Typical Low $87.10 Median $691.83 Typical High $4,570.88 | Facility | None | $87.10 | $691.83 | $4,570.88 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $10,000.00 | Facility | None | $457.09 | $912.01 | $10,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $407.38 Typical High $6,606.93 | Professional | None | $141.25 | $407.38 | $6,606.93 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $151,356.12 Typical High $251,188.64 | Facility | None | $676.08 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $3,090.30 | Facility | None | $123.03 | $489.78 | $3,090.30 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $169.82 |
Where California sits
The same service costs 74.1 times more in Alaska than in South Carolina. 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· 10th of 51
$1,698
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.