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 $2,570.40 Median $10,471.29 Typical High $23,442.29 | Facility | None | $2,570.40 | $10,471.29 | $23,442.29 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $10,232.93 | Professional | None | $776.25 | $776.25 | $10,232.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,317.64 Median $14,791.08 Typical High $28,840.32 | Facility | None | $8,317.64 | $14,791.08 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $8,511.38 | Professional | None | $851.14 | $851.14 | $8,511.38 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $6,918.31 Typical High $15,848.93 | Facility | None | $64.57 | $6,918.31 | $15,848.93 |
Cigna Setting Facility Modifier None Typical Low $9,549.93 Median $12,882.50 Typical High $22,387.21 | Facility | None | $9,549.93 | $12,882.50 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
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 $9,120.11 Median $12,589.25 Typical High $21,877.62 | Facility | None | $9,120.11 | $12,589.25 | $21,877.62 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $10,000.00 Typical High $25,703.96 | Facility | None | $4,265.80 | $10,000.00 | $25,703.96 |
5 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 $389.05 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $77.62 |
Where California sits
The same service costs 281.8 times more in Minnesota 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· 13th of 51
$10,000
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.