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 $89.13 Median $91.20 Typical High $165.96 | Facility | None | $89.13 | $91.20 | $165.96 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | None | $89.13 | $91.20 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $316.23 | Facility | None | $100.00 | $154.88 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $194.98 | Professional | None | $93.33 | $93.33 | $194.98 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $158.49 Typical High $275.42 | Facility | None | $77.62 | $158.49 | $275.42 |
Blue Shield Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $288.40 | Professional | None | $89.13 | $109.65 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $138.04 | Professional | None | $81.28 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $165.96 Typical High $223.87 | Facility | None | $93.33 | $165.96 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $251.19 | Professional | None | $81.28 | $112.20 | $251.19 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $162.18 Typical High $251.19 | Facility | None | $91.20 | $162.18 | $251.19 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | None | $89.13 | $89.13 | $109.65 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $467.74 | Facility | None | $89.13 | $89.13 | $467.74 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $389.05 | Professional | None | $93.33 | $93.33 | $389.05 |
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 $44.67 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $44.67 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.91 | $9.12 | $9.12 |
Where California sits
The same service costs 5.9 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· 13th of 51
$107
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.