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 $75.86 Median $75.86 Typical High $134.90 | Facility | None | $75.86 | $75.86 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $186.21 | Facility | None | $72.44 | $95.50 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $77.62 Typical High $147.91 | Professional | None | $40.74 | $77.62 | $147.91 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $79.43 Typical High $112.20 | Facility | None | $70.79 | $79.43 | $112.20 |
Blue Shield Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $158.49 | Professional | None | $56.23 | $67.61 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $154.88 Typical High $234.42 | Facility | None | $77.62 | $154.88 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $123.03 | Professional | None | $53.70 | $85.11 | $123.03 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $208.93 | Facility | None | $56.23 | $107.15 | $208.93 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | None | $77.62 | $77.62 | $83.18 |
Sutter Health Plus Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
United Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $346.74 | Professional | None | $75.86 | $75.86 | $346.74 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where California sits
The same service costs 25.1 times more in Alabama than in Nebraska. 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· 14th of 51
$77.62
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.