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 $512.86 Median $512.86 Typical High $912.01 | Facility | None | $512.86 | $512.86 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $562.34 Median $912.01 Typical High $1,862.09 | Facility | None | $562.34 | $912.01 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,000.00 | Professional | None | $524.81 | $524.81 | $1,000.00 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $524.81 Typical High $776.25 | Facility | None | $75.86 | $524.81 | $776.25 |
Blue Shield Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,348.96 | Professional | None | $512.86 | $602.56 | $1,348.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $758.58 | Professional | None | $512.86 | $660.69 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,047.13 Typical High $1,584.89 | Facility | None | $524.81 | $1,047.13 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,202.26 | Professional | None | $562.34 | $851.14 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $1,412.54 | Facility | None | $524.81 | $724.44 | $1,412.54 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $1,819.70 | Facility | None | $537.03 | $537.03 | $1,819.70 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,412.54 | Professional | None | $512.86 | $512.86 | $1,412.54 |
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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where California sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 31st of 51
$525
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.