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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $302.00 | Professional | None | $204.17 | $263.03 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $380.19 | Facility | None | $275.42 | $323.59 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $309.03 Typical High $512.86 | Professional | None | $81.28 | $309.03 | $512.86 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $263.03 Typical High $371.54 | Facility | None | $74.13 | $263.03 | $371.54 |
Blue Shield Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $537.03 | Professional | None | $257.04 | $302.00 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $380.19 | Professional | None | $257.04 | $331.13 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $575.44 Typical High $870.96 | Facility | None | $288.40 | $575.44 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $407.38 | Professional | None | $181.97 | $251.19 | $407.38 |
Molina Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $371.54 Typical High $724.44 | Facility | None | $95.50 | $371.54 | $724.44 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $288.40 Typical High $288.40 | Professional | None | $89.13 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $691.83 | Professional | None | $281.84 | $309.03 | $691.83 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $26.30 |
Where California sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 8th of 51
$288
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.