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 $794.33 Median $794.33 Typical High $1,318.26 | Facility | None | $794.33 | $794.33 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | None | $794.33 | $794.33 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $1,096.48 Typical High $3,311.31 | Facility | None | $851.14 | $1,096.48 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $812.83 Typical High $1,584.89 | Professional | None | $46.77 | $812.83 | $1,584.89 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $812.83 Typical High $1,202.26 | Facility | None | $75.86 | $812.83 | $1,202.26 |
Blue Shield Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,348.96 | $3,388.44 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,202.26 | Professional | None | $794.33 | $1,047.13 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,621.81 Typical High $2,454.71 | Facility | None | $812.83 | $1,621.81 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $4,168.69 Typical High $5,888.44 | Professional | None | $2,754.23 | $4,168.69 | $5,888.44 |
Molina Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $1,148.15 Typical High $2,187.76 | Facility | None | $81.28 | $1,148.15 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $107.15 Median $812.83 Typical High $812.83 | Professional | None | $107.15 | $812.83 | $812.83 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
United Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $2,754.23 | Professional | None | $794.33 | $794.33 | $2,754.23 |
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 $398.11 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $81.28 |
Where California sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 36th of 51
$813
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.