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 $32.36 Median $33.11 Typical High $208.93 | Facility | None | $32.36 | $33.11 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $37.15 | Professional | None | $32.36 | $33.11 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $54.95 Typical High $112.20 | Facility | None | $35.48 | $54.95 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $45.71 | Professional | None | $33.88 | $33.88 | $45.71 |
Blue Shield Setting Facility Modifier None Typical Low $32.36 Median $33.88 Typical High $74.13 | Facility | None | $32.36 | $33.88 | $74.13 |
Blue Shield Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | None | $32.36 | $32.36 | $39.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $35.48 | Professional | None | $32.36 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $58.88 Typical High $81.28 | Facility | None | $33.88 | $58.88 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | None | $32.36 | $32.36 | $38.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $57.54 | Professional | None | $29.51 | $32.36 | $57.54 |
Lucent Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $56.23 Typical High $87.10 | Facility | None | $32.36 | $56.23 | $87.10 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | None | $32.36 | $32.36 | $39.81 |
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 $16.22 Median $16.60 Typical High $16.60 | Professional | 52 · Reduced service | $16.22 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 53 · Discontinued | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.31 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.24 | $3.31 | $3.31 |
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· 34th of 51
$32.36
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.