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 $87.10 Median $93.33 Typical High $97.72 | Facility | None | $87.10 | $93.33 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $120.23 | Professional | None | $87.10 | $95.50 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $831.76 | Facility | None | $162.18 | $204.17 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $323.59 | Professional | None | $123.03 | $165.96 | $323.59 |
Blue Shield Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $141.25 | Professional | None | $69.18 | $100.00 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $158.49 | Professional | None | $89.13 | $97.72 | $158.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $104.71 | Professional | None | $77.62 | $93.33 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $83.18 Typical High $194.98 | Professional | None | $74.13 | $83.18 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | None | $512.86 | $691.83 | $691.83 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $120.23 | Professional | None | $33.11 | $33.11 | $120.23 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $154.88 | Facility | None | $87.10 | $123.03 | $154.88 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $95.50 Typical High $158.49 | Professional | None | $89.13 | $95.50 | $158.49 |
Sutter Health Plus Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $173.78 | Professional | None | $67.61 | $95.50 | $173.78 |
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 $41.69 Median $43.65 Typical High $48.98 | Professional | 52 · Reduced service | $41.69 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.88 Typical High $14.79 | Professional | 55 · Aftercare only | $12.59 | $12.88 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.71 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.32 | $8.71 | $9.77 |
Where California sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 14th of 51
$126
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.