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 $467.74 Median $467.74 Typical High $831.76 | Facility | None | $467.74 | $467.74 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,698.24 | Facility | None | $467.74 | $645.65 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $478.63 Typical High $912.01 | Professional | None | $107.15 | $478.63 | $912.01 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $478.63 Typical High $691.83 | Facility | None | $77.62 | $478.63 | $691.83 |
Blue Shield Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,318.26 | Professional | None | $501.19 | $588.84 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $954.99 Typical High $1,445.44 | Facility | None | $478.63 | $954.99 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $1,000.00 | Professional | None | $478.63 | $724.44 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $660.69 Typical High $1,288.25 | Facility | None | $245.47 | $660.69 | $1,288.25 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $478.63 | Professional | None | $281.84 | $478.63 | $478.63 |
Sutter Health Plus Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
United Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,258.93 | Professional | None | $467.74 | $467.74 | $1,258.93 |
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 $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Where California sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 29th of 51
$479
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.