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 $245.47 Median $245.47 Typical High $323.59 | Facility | None | $245.47 | $245.47 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $354.81 | Professional | None | $245.47 | $245.47 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $407.38 Typical High $831.76 | Facility | None | $263.03 | $407.38 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $724.44 | Professional | None | $239.88 | $251.19 | $724.44 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $263.03 Typical High $616.60 | Facility | None | $100.00 | $263.03 | $616.60 |
Blue Shield Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,000.00 | Professional | None | $537.03 | $758.58 | $1,000.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $363.08 | Professional | None | $218.78 | $269.15 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $457.09 Typical High $1,000.00 | Facility | None | $309.03 | $457.09 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $676.08 | Professional | None | $218.78 | $295.12 | $676.08 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $457.09 Typical High $1,000.00 | Facility | None | $245.47 | $457.09 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $398.11 | Professional | None | $245.47 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $870.96 | Professional | None | $275.42 | $288.40 | $870.96 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where California sits
The same service costs 8.7 times more in Alabama than in Rhode Island. 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· 9th of 51
$389
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.