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 $213.80 | Professional | None | $194.98 | $194.98 | $213.80 |
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 $407.38 | Professional | None | $190.55 | $229.09 | $407.38 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $186.21 Typical High $234.42 | Facility | None | $75.86 | $186.21 | $234.42 |
Blue Shield Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $436.52 | Professional | None | $162.18 | $199.53 | $436.52 |
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 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $630.96 | Professional | None | $245.47 | $338.84 | $630.96 |
Molina Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $275.42 Typical High $562.34 | Facility | None | $162.18 | $275.42 | $562.34 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | None | $194.98 | $213.80 | $213.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $478.63 | Facility | None | $194.98 | $194.98 | $478.63 |
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 1.9 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· 6th 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.