How much rates vary
Facilitymedian $339 · 10th to 90th $95 to $631Professionalmedian $229 · 10th to 90th $224 to $501
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 $229.09 Median $281.84 Typical High $588.84 | Facility | None | $229.09 | $281.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $245.47 Median $380.19 Typical High $776.25 | Facility | None | $245.47 | $380.19 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $218.78 Typical High $371.54 | Facility | None | $75.86 | $218.78 | $371.54 |
Blue Shield Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | None | $229.09 | $229.09 | $281.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | None | $229.09 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $416.87 Typical High $575.44 | Facility | None | $229.09 | $416.87 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Contra Costa Health Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $269.15 | Professional | None | $218.78 | $223.87 | $269.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $426.58 | Professional | None | $204.17 | $229.09 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $407.38 Typical High $630.96 | Facility | None | $229.09 | $407.38 | $630.96 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $269.15 | Professional | None | $208.93 | $223.87 | $269.15 |
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 $114.82 Median $141.25 Typical High $295.12 | Facility | 52 · Reduced service | $114.82 | $141.25 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $56.23 Typical High $117.49 | Facility | 53 · Discontinued | $45.71 | $56.23 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $41.69 Typical High $87.10 | Facility | 55 · Aftercare only | $33.88 | $41.69 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $58.88 | Facility | 56 · Pre-op care only | $22.91 | $28.18 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $33.88 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
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· 44th of 51
$229
AK $282TN $229
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.