How much rates vary
Facilitymedian $4,266 · 10th to 90th $95 to $7,943Professionalmedian $2,884 · 10th to 90th $2,818 to $6,026
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 $2,884.03 Median $3,981.07 Typical High $7,413.10 | Facility | None | $2,884.03 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,884.03 | $2,884.03 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $4,786.30 Typical High $9,772.37 | Facility | None | $3,090.30 | $4,786.30 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,981.07 | Professional | None | $2,951.21 | $2,951.21 | $3,981.07 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $2,754.23 Typical High $4,168.69 | Facility | None | $75.86 | $2,754.23 | $4,168.69 |
Blue Shield Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,630.78 | Professional | None | $2,884.03 | $2,884.03 | $3,630.78 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,884.03 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,884.03 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $5,248.07 Typical High $7,244.36 | Facility | None | $2,884.03 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,691.53 | $2,818.38 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $2,818.38 Typical High $5,370.32 | Professional | None | $2,511.89 | $2,818.38 | $5,370.32 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Providence Setting Facility Modifier None Typical Low $2,884.03 Median $5,128.61 Typical High $7,943.28 | Facility | None | $2,884.03 | $5,128.61 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,168.69 | $4,168.69 | $4,168.69 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $7,762.47 | Facility | None | $2,884.03 | $2,884.03 | $7,762.47 |
United Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,570.40 | $2,818.38 | $3,388.44 |
8 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 Facility Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,949.84 Typical High $3,715.35 | Facility | 52 · Reduced service | $1,445.44 | $1,949.84 | $3,715.35 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $575.44 Median $794.33 Typical High $1,479.11 | Facility | 53 · Discontinued | $575.44 | $794.33 | $1,479.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $426.58 Median $588.84 Typical High $1,122.02 | Facility | 55 · Aftercare only | $426.58 | $588.84 | $1,122.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $288.40 Median $398.11 Typical High $741.31 | Facility | 56 · Pre-op care only | $288.40 | $398.11 | $741.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $288.40 |
Where California sits
Rates are fairly even across states for this service. 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· 37th of 51
$2,884
AK $3,548UT $2,884
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.