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 $11.22 Median $12.88 Typical High $17.38 | Professional | None | $11.22 | $12.88 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $56.23 Typical High $57.54 | Facility | None | $20.89 | $56.23 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $20.42 Typical High $41.69 | Professional | None | $13.18 | $20.42 | $41.69 |
Blue Shield Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $26.30 | Professional | None | $10.72 | $15.49 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $16.22 | Professional | None | $12.02 | $13.18 | $16.22 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.47 Median $12.88 Typical High $25.70 | Professional | None | $10.47 | $12.88 | $25.70 |
Lucent Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Professional | None | $85.11 | $85.11 | $102.33 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $11.48 Median $16.98 Typical High $28.84 | Facility | None | $11.48 | $16.98 | $28.84 |
Providence Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $25.70 | Professional | None | $10.72 | $10.72 | $25.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $10.47 Median $14.45 Typical High $26.30 | Professional | None | $10.47 | $14.45 | $26.30 |
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 $4.57 Median $5.75 Typical High $6.92 | Professional | 52 · Reduced service | $4.57 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.29 Typical High $2.75 | Professional | 53 · Discontinued | $1.86 | $2.29 | $2.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.92 Median $8.71 Typical High $10.23 | Professional | 54 · Surgery only | $6.92 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.38 Median $1.74 Typical High $2.04 | Professional | 55 · Aftercare only | $1.38 | $1.74 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $1.15 Typical High $1.38 | Professional | 56 · Pre-op care only | $0.91 | $1.15 | $1.38 |
Where California sits
The same service costs 3.3 times more in Alaska than in Delaware. 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· 21st of 51
$16.98
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.