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 $53.70 Median $53.70 Typical High $95.50 | Facility | None | $53.70 | $53.70 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | None | $53.70 | $53.70 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $57.54 Typical High $63.10 | Facility | None | $0.03 | $57.54 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $54.95 Typical High $109.65 | Professional | None | $26.30 | $54.95 | $109.65 |
Blue Shield Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $85.11 | Facility | None | $54.95 | $54.95 | $85.11 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $162.18 | Professional | None | $60.26 | $70.79 | $162.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $85.11 | Professional | None | $56.23 | $74.13 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $109.65 Typical High $165.96 | Facility | None | $54.95 | $109.65 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $75.86 Typical High $147.91 | Facility | None | $48.98 | $75.86 | $147.91 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $147.91 | Professional | None | $56.23 | $56.23 | $147.91 |
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 $26.92 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $26.92 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.50 |
Where California sits
The same service costs 1.6 times more in Arizona than in California. 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· 51st of 51
$54.95
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.