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 $933.25 Median $8,128.31 Typical High $19,054.61 | Facility | None | $933.25 | $8,128.31 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $389.05 | Professional | None | $302.00 | $346.74 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $8,511.38 Typical High $16,982.44 | Facility | None | $4,570.88 | $8,511.38 | $16,982.44 |
Blue Shield Setting Facility Modifier None Typical Low $97.72 Median $2,089.30 Typical High $6,918.31 | Facility | None | $97.72 | $2,089.30 | $6,918.31 |
Blue Shield Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $562.34 | Professional | None | $281.84 | $407.38 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,495.41 Typical High $9,120.11 | Facility | None | $758.58 | $5,495.41 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $549.54 | Professional | None | $407.38 | $446.68 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $831.76 | Professional | None | $363.08 | $436.52 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $3,019.95 | Professional | None | $2,290.87 | $2,290.87 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $5,248.07 Typical High $8,912.51 | Facility | None | $630.96 | $5,248.07 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $6,760.83 Typical High $18,620.87 | Facility | None | $2,884.03 | $6,760.83 | $18,620.87 |
United Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $616.60 | Professional | None | $288.40 | $380.19 | $616.60 |
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 $151.36 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $151.36 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $223.87 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $34.67 | $38.90 |
Where California sits
The same service costs 4.5 times more in Alaska 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· 32nd of 51
$427
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.