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 $87.10 Median $87.10 Typical High $154.88 | Facility | None | $87.10 | $87.10 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $102.33 Typical High $128.82 | Facility | None | $87.10 | $102.33 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $269.15 | Professional | None | $89.13 | $89.13 | $269.15 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $89.13 Typical High $134.90 | Facility | None | $75.86 | $89.13 | $134.90 |
Blue Shield Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $245.47 | Professional | None | $91.20 | $107.15 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $269.15 | Facility | None | $89.13 | $177.83 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $239.88 | Facility | None | $89.13 | $125.89 | $239.88 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $190.55 | Professional | None | $89.13 | $89.13 | $190.55 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $239.88 | Professional | None | $87.10 | $87.10 | $239.88 |
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 $43.65 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $8.71 |
Where California sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 21st of 51
$89.13
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.