How much rates vary
Facilitymedian $209 · 10th to 90th $95 to $389Professionalmedian $145 · 10th to 90th $138 to $603
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 $144.54 Median $173.78 Typical High $363.08 | Facility | None | $144.54 | $173.78 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $213.80 | Professional | None | $144.54 | $144.54 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $489.78 | Facility | None | $154.88 | $239.88 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $251.19 | Facility | None | $77.62 | $144.54 | $251.19 |
Blue Shield Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | None | $144.54 | $144.54 | $177.83 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | None | $144.54 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $263.03 Typical High $363.08 | Facility | None | $144.54 | $263.03 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | None | $138.04 | $138.04 | $165.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $251.19 | Professional | None | $128.82 | $141.25 | $251.19 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | None | $602.56 | $616.60 | $616.60 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $257.04 Typical High $398.11 | Facility | None | $144.54 | $257.04 | $398.11 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $380.19 | Facility | None | $144.54 | $144.54 | $380.19 |
United Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $165.96 | Professional | None | $123.03 | $138.04 | $165.96 |
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 $72.44 Median $87.10 Typical High $181.97 | Facility | 52 · Reduced service | $72.44 | $87.10 | $181.97 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.84 Median $34.67 Typical High $72.44 | Facility | 53 · Discontinued | $28.84 | $34.67 | $72.44 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $53.70 | Facility | 55 · Aftercare only | $21.38 | $25.70 | $53.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.45 Median $17.38 Typical High $36.31 | Facility | 56 · Pre-op care only | $14.45 | $17.38 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $14.45 |
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· 46th of 51
$145
AK $178TN $145
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.