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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $380.19 | Professional | None | $194.98 | $194.98 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $281.84 | Facility | None | $204.17 | $239.88 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $229.09 Typical High $416.87 | Professional | None | $190.55 | $229.09 | $416.87 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $186.21 Typical High $281.84 | Facility | None | $77.62 | $186.21 | $281.84 |
Blue Shield Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $446.68 | Professional | None | $190.55 | $218.78 | $446.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $281.84 | Professional | None | $190.55 | $245.47 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $645.65 | Facility | None | $213.80 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $407.38 | Professional | None | $97.72 | $134.90 | $407.38 |
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 $151.36 Median $275.42 Typical High $562.34 | Facility | None | $151.36 | $275.42 | $562.34 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $213.80 | Professional | None | $131.83 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
United Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $512.86 | Professional | None | $213.80 | $229.09 | $512.86 |
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 $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where California sits
The same service costs 8.3 times more in Arizona than in Alabama. 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· 5th of 51
$229
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.