How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $158.49 Median $158.49 Typical High $199.53 | Facility | None | $158.49 | $158.49 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $199.53 | Professional | None | $158.49 | $158.49 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $331.13 | Professional | None | $173.78 | $331.13 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $309.03 | Professional | None | $134.90 | $213.80 | $309.03 |
Blue Shield Setting Facility Modifier None Typical Low $257.04 Median $851.14 Typical High $1,071.52 | Facility | None | $257.04 | $851.14 | $1,071.52 |
Blue Shield Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $154.88 | Professional | None | $83.18 | $120.23 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $524.81 | Facility | None | $457.09 | $457.09 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Contra Costa Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $426.58 | Professional | None | $177.83 | $199.53 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,698.24 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $338.84 | Professional | None | $60.26 | $60.26 | $338.84 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $223.87 Typical High $457.09 | Facility | None | $158.49 | $223.87 | $457.09 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $831.76 | Facility | None | $537.03 | $537.03 | $831.76 |
United Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $338.84 | Professional | None | $131.83 | $229.09 | $338.84 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where California sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 50th of 51
$166
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.