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 $158.49 Median $158.49 Typical High $288.40 | Facility | None | $158.49 | $158.49 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $575.44 | Facility | None | $177.83 | $281.84 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $316.23 | Professional | None | $162.18 | $162.18 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $162.18 Typical High $309.03 | Facility | None | $77.62 | $162.18 | $309.03 |
Blue Shield Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $426.58 | Professional | None | $158.49 | $186.21 | $426.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $239.88 | Professional | None | $158.49 | $208.93 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $489.78 | Facility | None | $162.18 | $323.59 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $407.38 | Professional | None | $181.97 | $323.59 | $407.38 |
Molina Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $436.52 | Facility | None | $162.18 | $229.09 | $436.52 |
Providence Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $562.34 | Facility | None | $165.96 | $165.96 | $562.34 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $436.52 | Professional | None | $158.49 | $158.49 | $436.52 |
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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where California sits
The same service costs 1.7 times more in Arizona than in Mississippi. 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
$166
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.