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 $3,548.13 Median $10,715.19 Typical High $22,908.68 | Facility | None | $3,548.13 | $10,715.19 | $22,908.68 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $11,220.18 | Professional | None | $1,148.15 | $1,148.15 | $11,220.18 |
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 $6,918.31 Typical High $17,782.79 | Facility | None | $64.57 | $6,918.31 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $13,803.84 Median $20,417.38 Typical High $33,884.42 | Facility | None | $13,803.84 | $20,417.38 | $33,884.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Professional | None | $18,620.87 | $18,620.87 | $18,620.87 |
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 $13,182.57 Median $20,892.96 Typical High $34,673.69 | Facility | None | $13,182.57 | $20,892.96 | $34,673.69 |
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 $4,265.80 Median $10,000.00 Typical High $29,512.09 | Facility | None | $4,265.80 | $10,000.00 | $29,512.09 |
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 $575.44 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $114.82 |
Where California sits
The same service costs 5754.4 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· 16th of 51
$12,589
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.