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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $120.23 Typical High $134.90 | Professional | None | $40.74 | $120.23 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $147.91 Typical High $181.97 | Facility | None | $134.90 | $147.91 | $181.97 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $141.25 Typical High $251.19 | Professional | None | $10.00 | $141.25 | $251.19 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $120.23 Typical High $169.82 | Facility | None | $74.13 | $120.23 | $169.82 |
Blue Shield Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $288.40 | Professional | None | $117.49 | $138.04 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $177.83 | Professional | None | $117.49 | $151.36 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $275.42 Typical High $416.87 | Facility | None | $138.04 | $275.42 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $407.38 | Professional | None | $95.50 | $131.83 | $407.38 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Providence Setting Facility Modifier None Typical Low $52.48 Median $169.82 Typical High $371.54 | Facility | None | $52.48 | $169.82 | $371.54 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $138.04 Typical High $138.04 | Professional | None | $72.44 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $316.23 | Professional | None | $131.83 | $141.25 | $316.23 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where California sits
The same service costs 5.1 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
$141
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.