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 $75,857.76 Median $75,857.76 Typical High $125,892.54 | Facility | None | $75,857.76 | $75,857.76 | $125,892.54 |
Aetna Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $75,857.76 | Professional | None | $75,857.76 | $75,857.76 | $75,857.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $57,543.99 Median $83,176.38 Typical High $112,201.85 | Facility | None | $57,543.99 | $83,176.38 | $112,201.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $56,234.13 Median $70,794.58 Typical High $114,815.36 | Professional | None | $56,234.13 | $70,794.58 | $114,815.36 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $70,794.58 Typical High $109,647.82 | Facility | None | $74.13 | $70,794.58 | $109,647.82 |
Blue Shield Setting Professional Modifier None Typical Low $75,857.76 Median $89,125.09 Typical High $154,881.66 | Professional | None | $75,857.76 | $89,125.09 | $154,881.66 |
Cigna Setting Facility Modifier None Typical Low $77,624.71 Median $154,881.66 Typical High $234,422.88 | Facility | None | $77,624.71 | $154,881.66 | $234,422.88 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47,863.01 Median $72,443.60 Typical High $100,000.00 | Professional | None | $47,863.01 | $72,443.60 | $100,000.00 |
Molina Setting Professional Modifier None Typical Low $33,884.42 Median $33,884.42 Typical High $33,884.42 | Professional | None | $33,884.42 | $33,884.42 | $33,884.42 |
Providence Setting Facility Modifier None Typical Low $38,904.51 Median $109,647.82 Typical High $208,929.61 | Facility | None | $38,904.51 | $109,647.82 | $208,929.61 |
Providence Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
United Setting Professional Modifier None Typical Low $75,857.76 Median $75,857.76 Typical High $169,824.37 | Professional | None | $75,857.76 | $75,857.76 | $169,824.37 |
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 $38,018.94 Median $38,018.94 Typical High $38,018.94 | Professional | 52 · Reduced service | $38,018.94 | $38,018.94 | $38,018.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | 53 · Discontinued | $15,135.61 | $15,135.61 | $15,135.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | 55 · Aftercare only | $11,481.54 | $11,481.54 | $11,481.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | 56 · Pre-op care only | $7,585.78 | $7,585.78 | $7,585.78 |
Where California sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 39th of 51
$75,858
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.