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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $602.56 Typical High $1,318.26 | Facility | None | $457.09 | $602.56 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $457.09 Typical High $851.14 | Professional | None | $81.28 | $457.09 | $851.14 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $457.09 Typical High $676.08 | Facility | None | $77.62 | $457.09 | $676.08 |
Blue Shield Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,096.48 | Professional | None | $489.78 | $575.44 | $1,096.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $676.08 | Professional | None | $457.09 | $588.84 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $1,548.82 | Facility | None | $501.19 | $1,023.29 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,737.80 | Professional | None | $660.69 | $891.25 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $660.69 Typical High $1,348.96 | Facility | None | $251.19 | $660.69 | $1,348.96 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $501.19 Typical High $501.19 | Professional | None | $194.98 | $501.19 | $501.19 |
Sutter Health Plus Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $776.25 | Facility | None | $354.81 | $354.81 | $776.25 |
United Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $1,230.27 | Professional | None | $512.86 | $537.03 | $1,230.27 |
4 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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Where California sits
The same service costs 4.9 times more in Alabama 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· 23rd of 51
$501
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.