How much rates vary
Facilitymedian $490 · 10th to 90th $95 to $912Professionalmedian $331 · 10th to 90th $324 to $724
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 $331.13 Median $407.38 Typical High $851.14 | Facility | None | $331.13 | $407.38 | $851.14 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $549.54 Typical High $1,148.15 | Facility | None | $354.81 | $549.54 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $457.09 | Professional | None | $338.84 | $338.84 | $457.09 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $323.59 Typical High $575.44 | Facility | None | $77.62 | $323.59 | $575.44 |
Blue Shield Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | None | $331.13 | $331.13 | $416.87 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | None | $323.59 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $602.56 Typical High $831.76 | Facility | None | $331.13 | $602.56 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $316.23 Median $323.59 Typical High $389.05 | Professional | None | $316.23 | $323.59 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $707.95 | Professional | None | $295.12 | $331.13 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $588.84 Typical High $912.01 | Facility | None | $331.13 | $588.84 | $912.01 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $389.05 | Professional | None | $302.00 | $323.59 | $389.05 |
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 $165.96 Median $204.17 Typical High $426.58 | Facility | 52 · Reduced service | $165.96 | $204.17 | $426.58 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $81.28 Typical High $169.82 | Facility | 53 · Discontinued | $66.07 | $81.28 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $61.66 Typical High $128.82 | Facility | 55 · Aftercare only | $48.98 | $61.66 | $128.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $40.74 Typical High $85.11 | Facility | 56 · Pre-op care only | $33.11 | $40.74 | $85.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
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· 19th of 51
$331
AK $407VT $331
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.