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 $812.83 Median $812.83 Typical High $1,445.44 | Facility | None | $812.83 | $812.83 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $1,380.38 Typical High $2,884.03 | Facility | None | $933.25 | $1,380.38 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $1,122.02 Typical High $1,548.82 | Professional | None | $100.00 | $1,122.02 | $1,548.82 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $831.76 Typical High $1,412.54 | Facility | None | $75.86 | $831.76 | $1,412.54 |
Blue Shield Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,202.26 | Professional | None | $812.83 | $1,047.13 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,659.59 Typical High $2,511.89 | Facility | None | $831.76 | $1,659.59 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,511.89 | Facility | None | $812.83 | $1,479.11 | $2,511.89 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $2,344.23 | Facility | None | $831.76 | $831.76 | $2,344.23 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,884.03 | $2,884.03 |
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 $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Where California sits
The same service costs 295.1 times more in Alabama 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· 12th of 51
$912
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.