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 $338.84 Median $338.84 Typical High $588.84 | Facility | None | $338.84 | $338.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $1,148.15 | Facility | None | $363.08 | $562.34 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $891.25 | Professional | None | $316.23 | $331.13 | $891.25 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $331.13 Typical High $478.63 | Facility | None | $75.86 | $331.13 | $478.63 |
Blue Shield Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $912.01 | Professional | None | $338.84 | $407.38 | $912.01 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $501.19 | Professional | None | $302.00 | $371.54 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $616.60 Typical High $851.14 | Facility | None | $346.74 | $616.60 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $891.25 | Professional | None | $302.00 | $407.38 | $891.25 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $602.56 Typical High $933.25 | Facility | None | $338.84 | $602.56 | $933.25 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | None | $338.84 | $338.84 | $346.74 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $870.96 | Professional | None | $331.13 | $331.13 | $870.96 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $50.12 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where California sits
The same service costs 1.5 times more in Arizona than in Rhode Island. 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· 30th of 51
$339
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.