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 $181.97 Median $199.53 Typical High $208.93 | Facility | None | $181.97 | $199.53 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $208.93 | Professional | None | $169.82 | $181.97 | $208.93 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $407.38 | Professional | None | $89.13 | $141.25 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | None | $173.78 | $190.55 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $467.74 | Professional | None | $147.91 | $181.97 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,202.26 | $1,202.26 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $371.54 | Facility | None | $181.97 | $257.04 | $371.54 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | None | $144.54 | $144.54 | $162.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $851.14 | Professional | None | $158.49 | $263.03 | $851.14 |
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 $85.11 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $85.11 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $33.88 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $27.54 Typical High $30.90 | Professional | 55 · Aftercare only | $25.70 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $20.89 |
Where California sits
The same service costs 4.7 times more in Alaska than in Alabama. 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· 37th of 51
$191
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.