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 $229.09 Median $229.09 Typical High $354.81 | Facility | None | $229.09 | $229.09 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $446.68 | Professional | None | $229.09 | $251.19 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $338.84 | Facility | None | $245.47 | $288.40 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $891.25 | Professional | None | $269.15 | $269.15 | $891.25 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $229.09 Typical High $338.84 | Facility | None | $75.86 | $229.09 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $575.44 | Professional | None | $251.19 | $288.40 | $575.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $338.84 | Professional | None | $223.87 | $295.12 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $501.19 Typical High $758.58 | Facility | None | $251.19 | $501.19 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $457.09 | Professional | None | $251.19 | $275.42 | $457.09 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Providence Setting Facility Modifier None Typical Low $239.88 Median $331.13 Typical High $676.08 | Facility | None | $239.88 | $331.13 | $676.08 |
Providence 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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
United Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $602.56 | Professional | None | $251.19 | $269.15 | $602.56 |
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 $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Where California sits
The same service costs 2.0 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
$269
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.