How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $380.19 Median $380.19 Typical High $758.58 | Facility | None | $380.19 | $380.19 | $758.58 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $416.87 | Professional | None | $354.81 | $380.19 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $42.66 Typical High $50.12 | Professional | None | $10.00 | $42.66 | $50.12 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $346.74 | Professional | None | $208.93 | $302.00 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $616.60 | Professional | None | $489.78 | $489.78 | $616.60 |
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 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $537.03 Typical High $676.08 | Facility | None | $380.19 | $537.03 | $676.08 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | None | $60.26 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $524.81 | Professional | None | $199.53 | $223.87 | $524.81 |
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 $177.83 Median $186.21 Typical High $208.93 | Professional | 52 · Reduced service | $177.83 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $72.44 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $53.70 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $41.69 |
Where California sits
The same service costs 38.0 times more in Minnesota than in Connecticut. 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· 19th of 51
$302
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.