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 $165.96 Median $173.78 Typical High $204.17 | Facility | None | $165.96 | $173.78 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $213.80 | Professional | None | $165.96 | $173.78 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $29.51 Typical High $123.03 | Facility | None | $23.44 | $29.51 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $208.93 | Professional | None | $23.99 | $23.99 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $331.13 | Professional | None | $181.97 | $181.97 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $758.58 | Professional | None | $213.80 | $251.19 | $758.58 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $223.87 Typical High $302.00 | Facility | None | $165.96 | $223.87 | $302.00 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $1,174.90 | Professional | None | $162.18 | $213.80 | $1,174.90 |
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 $83.18 Median $87.10 Typical High $107.15 | Professional | 52 · Reduced service | $83.18 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $33.11 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.60 | $17.38 | $21.38 |
Where California sits
The same service costs 6.6 times more in Alabama than in New York. 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· 47th of 51
$174
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.