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 $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $181.97 | Professional | None | $128.82 | $144.54 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $181.97 Typical High $208.93 | Facility | None | $154.88 | $181.97 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $302.00 | Professional | None | $102.33 | $169.82 | $302.00 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $144.54 Typical High $204.17 | Facility | None | $74.13 | $144.54 | $204.17 |
Blue Shield Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $354.81 | Professional | None | $141.25 | $165.96 | $354.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $208.93 | Professional | None | $141.25 | $181.97 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $316.23 Typical High $478.63 | Facility | None | $158.49 | $316.23 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $407.38 | Professional | None | $151.36 | $186.21 | $407.38 |
Molina Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $426.58 | Facility | None | $125.89 | $204.17 | $426.58 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $158.49 | Professional | None | $97.72 | $158.49 | $158.49 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $380.19 | Professional | None | $154.88 | $165.96 | $380.19 |
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 $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
Where California sits
The same service costs 1.9 times more in Arizona than in New Mexico. 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
$166
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.