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 $724.44 Median $776.25 Typical High $831.76 | Facility | None | $724.44 | $776.25 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $831.76 | Professional | None | $660.69 | $724.44 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,023.29 Typical High $4,265.80 | Facility | None | $812.83 | $1,023.29 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,288.25 | Professional | None | $794.33 | $831.76 | $1,288.25 |
Blue Shield Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $933.25 | Professional | None | $524.81 | $758.58 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,230.27 | Professional | None | $741.31 | $794.33 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,148.15 | Professional | None | $467.74 | $524.81 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $5,370.32 Median $7,413.10 Typical High $7,413.10 | Professional | None | $5,370.32 | $7,413.10 | $7,413.10 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,230.27 | Facility | None | $660.69 | $1,000.00 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,174.90 | Professional | None | $741.31 | $794.33 | $1,174.90 |
United Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $891.25 | Professional | None | $354.81 | $616.60 | $891.25 |
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 $331.13 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $331.13 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $83.18 |
Where California sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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· 23rd of 51
$832
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.