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 $239.88 Median $239.88 Typical High $338.84 | Facility | None | $239.88 | $239.88 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $426.58 | Professional | None | $239.88 | $263.03 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $933.25 | Professional | None | $186.21 | $223.87 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $263.03 Median $323.59 Typical High $1,148.15 | Facility | None | $263.03 | $323.59 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $501.19 | Professional | None | $158.49 | $281.84 | $501.19 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $239.88 Typical High $338.84 | Facility | None | $74.13 | $239.88 | $338.84 |
Blue Shield Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $588.84 | Professional | None | $257.04 | $302.00 | $588.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $354.81 | Professional | None | $234.42 | $302.00 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $524.81 Typical High $794.33 | Facility | None | $263.03 | $524.81 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $575.44 | Professional | None | $263.03 | $316.23 | $575.44 |
Molina Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $338.84 Typical High $707.95 | Facility | None | $251.19 | $338.84 | $707.95 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $645.65 | Professional | None | $245.47 | $257.04 | $645.65 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
Where California sits
The same service costs 2.1 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· 5th of 51
$282
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.