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 $107.15 Median $107.15 Typical High $194.98 | Facility | None | $107.15 | $107.15 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $128.82 Typical High $151.36 | Facility | None | $109.65 | $128.82 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $229.09 | Professional | None | $109.65 | $109.65 | $229.09 |
Blue Shield Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Blue Shield Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $302.00 | Professional | None | $114.82 | $134.90 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $234.42 | Facility | None | $107.15 | $154.88 | $234.42 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $257.04 | Professional | None | $112.20 | $138.04 | $257.04 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $346.74 | Professional | None | $128.82 | $128.82 | $346.74 |
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 $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where California sits
The same service costs 3.7 times more in Alaska than in Arkansas. 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· 33rd of 51
$115
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.