How much rates vary
Facilitymedian $1,862 · 10th to 90th $95 to $3,631Professionalmedian $1,259 · 10th to 90th $1,259 to $3,162
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 $1,258.93 Median $1,995.26 Typical High $3,311.31 | Facility | None | $1,258.93 | $1,995.26 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $4,365.16 | Facility | None | $1,380.38 | $2,137.96 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,318.26 | $1,737.80 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $1,445.44 Typical High $2,454.71 | Facility | None | $77.62 | $1,445.44 | $2,454.71 |
Blue Shield Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $3,090.30 | Facility | None | $1,258.93 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Contra Costa Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,318.26 | $1,445.44 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,258.93 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $3,311.31 | Facility | None | $1,258.93 | $2,137.96 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,786.30 | Facility | None | $1,258.93 | $1,258.93 | $4,786.30 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,348.96 | $1,513.56 |
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 $616.60 Median $1,000.00 Typical High $1,659.59 | Facility | 52 · Reduced service | $616.60 | $1,000.00 | $1,659.59 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $251.19 Median $398.11 Typical High $676.08 | Facility | 53 · Discontinued | $251.19 | $398.11 | $676.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $186.21 Median $295.12 Typical High $501.19 | Facility | 55 · Aftercare only | $186.21 | $295.12 | $501.19 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $125.89 Median $199.53 Typical High $331.13 | Facility | 56 · Pre-op care only | $125.89 | $199.53 | $331.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $616.60 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $125.89 |
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· 40th of 51
$1,259
AK $1,698FL $1,259
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.