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 $35.48 Median $109.65 Typical High $251.19 | Facility | None | $35.48 | $109.65 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $93.33 | Professional | None | $35.48 | $35.48 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $645.65 | Facility | None | $125.89 | $158.49 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $144.54 | Professional | None | $123.03 | $128.82 | $144.54 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $223.87 | Professional | None | $109.65 | $158.49 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | None | $776.25 | $831.76 | $831.76 |
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 $35.48 Median $51.29 Typical High $218.78 | Facility | None | $35.48 | $51.29 | $218.78 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $186.21 | Professional | None | $75.86 | $95.50 | $186.21 |
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 $17.78 Median $54.95 Typical High $125.89 | Facility | 52 · Reduced service | $17.78 | $54.95 | $125.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.08 Median $21.88 Typical High $50.12 | Facility | 53 · Discontinued | $7.08 | $21.88 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.37 Median $16.22 Typical High $37.15 | Facility | 55 · Aftercare only | $5.37 | $16.22 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.55 Median $10.96 Typical High $25.12 | Facility | 56 · Pre-op care only | $3.55 | $10.96 | $25.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $46.77 | Professional | 52 · Reduced service | $17.78 | $17.78 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $18.62 | Professional | 53 · Discontinued | $7.08 | $7.08 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $13.80 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $9.33 |
Where California sits
The same service costs 3.3 times more in Alaska than in Wyoming. 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· 16th of 51
$126
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.