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 $120.23 Median $120.23 Typical High $213.80 | Facility | None | $120.23 | $120.23 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $204.17 Typical High $416.87 | Facility | None | $128.82 | $204.17 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $234.42 | Professional | None | $97.72 | $123.03 | $234.42 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $123.03 Typical High $177.83 | Facility | None | $75.86 | $123.03 | $177.83 |
Blue Shield Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $295.12 | Professional | None | $120.23 | $141.25 | $295.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $177.83 | Professional | None | $120.23 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $245.47 Typical High $371.54 | Facility | None | $123.03 | $245.47 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $169.82 Typical High $331.13 | Facility | None | $123.03 | $169.82 | $331.13 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $316.23 | Facility | None | $123.03 | $123.03 | $316.23 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $323.59 | Professional | None | $120.23 | $120.23 | $323.59 |
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 $58.88 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where California sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 16th of 51
$123
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.