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 $2,238.72 Median $10,232.93 Typical High $23,442.29 | Facility | None | $2,238.72 | $10,232.93 | $23,442.29 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $6,760.83 | Professional | None | $691.83 | $691.83 | $6,760.83 |
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 $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $6,606.93 Typical High $15,488.17 | Facility | None | $64.57 | $6,606.93 | $15,488.17 |
Cigna Setting Facility Modifier None Typical Low $6,918.31 Median $17,782.79 Typical High $28,840.32 | Facility | None | $6,918.31 | $17,782.79 | $28,840.32 |
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 $11,220.18 Median $151,356.12 Typical High $251,188.64 | Facility | None | $11,220.18 | $151,356.12 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,380.38 Typical High $13,803.84 | Facility | None | $524.81 | $1,380.38 | $13,803.84 |
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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Where California sits
The same service costs 6025.6 times more in Oklahoma than in Maine. 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· 10th of 51
$7,943
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.