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 $117.49 Median $117.49 Typical High $213.80 | Facility | None | $117.49 | $117.49 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $331.13 | Facility | None | $123.03 | $162.18 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $234.42 | Professional | None | $120.23 | $120.23 | $234.42 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $213.80 | Facility | None | $77.62 | $120.23 | $213.80 |
Blue Shield Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $316.23 | Professional | None | $117.49 | $138.04 | $316.23 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $177.83 | Professional | None | $117.49 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $239.88 Typical High $363.08 | Facility | None | $120.23 | $239.88 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $120.23 Median $169.82 Typical High $323.59 | Facility | None | $120.23 | $169.82 | $323.59 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $354.81 | Facility | None | $95.50 | $95.50 | $354.81 |
United Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $323.59 | Professional | None | $117.49 | $117.49 | $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 $23.44 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $23.44 | $23.44 | $23.44 |
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 $11.75 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $11.75 |
Where California sits
The same service costs 2.3 times more in Texas 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· 12th of 51
$120
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.