How much rates vary
Facilitymedian $1,023 · 10th to 90th $95 to $1,905Professionalmedian $692 · 10th to 90th $692 to $1,445
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 $691.83 Median $870.96 Typical High $1,819.70 | Facility | None | $691.83 | $870.96 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,344.23 | Facility | None | $741.31 | $1,148.15 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $660.69 Typical High $1,000.00 | Facility | None | $75.86 | $660.69 | $1,000.00 |
Blue Shield Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $851.14 | Professional | None | $691.83 | $691.83 | $851.14 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $758.58 | Professional | None | $691.83 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,698.24 | Facility | None | $691.83 | $1,258.93 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Contra Costa Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | None | $691.83 | $691.83 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $1,202.26 | Professional | None | $616.60 | $691.83 | $1,202.26 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $1,230.27 Typical High $1,905.46 | Facility | None | $691.83 | $1,230.27 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $831.76 | Professional | None | $616.60 | $691.83 | $831.76 |
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 $338.84 Median $436.52 Typical High $912.01 | Facility | 52 · Reduced service | $338.84 | $436.52 | $912.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $363.08 | Facility | 53 · Discontinued | $138.04 | $173.78 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $102.33 Median $128.82 Typical High $269.15 | Facility | 55 · Aftercare only | $102.33 | $128.82 | $269.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $181.97 | Facility | 56 · Pre-op care only | $69.18 | $87.10 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
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· 18th of 51
$692
AK $832IN $692
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.