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 $128.82 Median $131.83 Typical High $151.36 | Facility | None | $128.82 | $131.83 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $151.36 | Professional | None | $123.03 | $128.82 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $138.04 Typical High $251.19 | Professional | None | $40.74 | $138.04 | $251.19 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $302.00 | Facility | None | $141.25 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $239.88 | Professional | None | $177.83 | $199.53 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $331.13 | Professional | None | $134.90 | $165.96 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $295.12 | Facility | None | $141.25 | $190.55 | $295.12 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $61.66 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $15.14 |
Where California sits
The same service costs 5.5 times more in North Dakota than in Kentucky. 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· 26th 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.