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 $53.70 Median $53.70 Typical High $97.72 | Facility | None | $53.70 | $53.70 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $79.43 | Facility | None | $54.95 | $64.57 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $54.95 Typical High $104.71 | Professional | None | $7.76 | $54.95 | $104.71 |
Blue Shield Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $81.28 | Facility | None | $54.95 | $54.95 | $81.28 |
Blue Shield Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $93.33 | Professional | None | $35.48 | $41.69 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $109.65 Typical High $165.96 | Facility | None | $54.95 | $109.65 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $57.54 Typical High $70.79 | Professional | None | $32.36 | $57.54 | $70.79 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Providence Setting Facility Modifier None Typical Low $18.62 Median $77.62 Typical High $147.91 | Facility | None | $18.62 | $77.62 | $147.91 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $54.95 Typical High $54.95 | Professional | None | $22.39 | $54.95 | $54.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $144.54 | Professional | None | $53.70 | $53.70 | $144.54 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where California sits
The same service costs 2.2 times more in Alaska than in Montana. 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· 17th of 51
$54.95
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.