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 $2,818.38 Median $9,120.11 Typical High $19,054.61 | Facility | None | $2,818.38 | $9,120.11 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $2,691.53 Typical High $9,772.37 | Professional | None | $100.00 | $2,691.53 | $9,772.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $5,011.87 Typical High $10,000.00 | Facility | None | $2,511.89 | $5,011.87 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $3,388.44 Typical High $30,902.95 | Professional | None | $42.66 | $3,388.44 | $30,902.95 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,348.96 Typical High $2,691.53 | Facility | None | $630.96 | $1,348.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $870.96 | Professional | None | $407.38 | $691.83 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $3,890.45 | Facility | None | $630.96 | $2,137.96 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $3,090.30 | Facility | None | $123.03 | $537.03 | $3,090.30 |
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 $48.98 Median $1,348.96 Typical High $4,897.79 | Professional | 52 · Reduced service | $48.98 | $1,348.96 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $537.03 Typical High $1,949.84 | Professional | 53 · Discontinued | $19.95 | $537.03 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $2,041.74 Typical High $7,244.36 | Professional | 54 · Surgery only | $74.13 | $2,041.74 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $407.38 Typical High $1,445.44 | Professional | 55 · Aftercare only | $14.79 | $407.38 | $1,445.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $269.15 Typical High $977.24 | Professional | 56 · Pre-op care only | $10.00 | $269.15 | $977.24 |
Where California sits
The same service costs 281.8 times more in North Dakota than in Vermont. 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· 2nd of 51
$1,445
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.