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 $165.96 Median $165.96 Typical High $295.12 | Facility | None | $165.96 | $165.96 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $251.19 | Professional | None | $165.96 | $181.97 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $275.42 Typical High $575.44 | Facility | None | $177.83 | $275.42 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $501.19 | Professional | None | $162.18 | $169.82 | $501.19 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $204.17 Typical High $309.03 | Facility | None | $75.86 | $204.17 | $309.03 |
Blue Shield Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $478.63 | Professional | None | $165.96 | $204.17 | $478.63 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $251.19 | Professional | None | $147.91 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $302.00 Typical High $416.87 | Facility | None | $173.78 | $302.00 | $416.87 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $446.68 | Professional | None | $147.91 | $199.53 | $446.68 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $295.12 Typical High $457.09 | Facility | None | $165.96 | $295.12 | $457.09 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $204.17 | Professional | None | $165.96 | $165.96 | $204.17 |
Sutter Health Plus Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $575.44 | Facility | None | $165.96 | $165.96 | $575.44 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $489.78 | Professional | None | $162.18 | $162.18 | $489.78 |
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 $83.18 Median $83.18 Typical High $83.18 | Professional | 52 · Reduced service | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $24.55 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $16.60 |
Where California sits
The same service costs 1.6 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· 13th of 51
$182
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.