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 $426.58 Median $467.74 Typical High $467.74 | Facility | None | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $478.63 | Professional | None | $407.38 | $426.58 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $2,630.27 | Facility | None | $501.19 | $645.65 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $870.96 | Professional | None | $436.52 | $512.86 | $870.96 |
Blue Shield Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $537.03 | Professional | None | $316.23 | $446.68 | $537.03 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | None | $562.34 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $691.83 | Professional | None | $446.68 | $478.63 | $691.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $691.83 | Professional | None | $380.19 | $630.96 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $1,071.52 | Professional | None | $524.81 | $575.44 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,715.35 | $4,466.84 | $4,466.84 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $977.24 | Facility | None | $426.58 | $645.65 | $977.24 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $676.08 | Professional | None | $446.68 | $467.74 | $676.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $741.31 | Professional | None | $354.81 | $489.78 | $741.31 |
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 $204.17 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $47.86 |
Where California sits
The same service costs 3.2 times more in Alaska than in New York. 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· 42nd of 51
$501
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.