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 $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $331.13 | Professional | None | $288.40 | $302.00 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $416.87 | Facility | None | $302.00 | $354.81 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $602.56 | Professional | None | $338.84 | $338.84 | $602.56 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $288.40 Typical High $407.38 | Facility | None | $74.13 | $288.40 | $407.38 |
Blue Shield Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $562.34 | Professional | None | $281.84 | $323.59 | $562.34 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $416.87 | Professional | None | $281.84 | $309.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $630.96 Typical High $954.99 | Facility | None | $316.23 | $630.96 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,737.80 | Professional | None | $407.38 | $407.38 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $407.38 Typical High $831.76 | Facility | None | $302.00 | $407.38 | $831.76 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $776.25 | Professional | None | $309.03 | $323.59 | $776.25 |
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 $144.54 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $28.84 |
Where California sits
The same service costs 10.0 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· 7th of 51
$331
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.