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 $346.74 Median $346.74 Typical High $354.81 | Facility | None | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $354.81 | Professional | None | $346.74 | $354.81 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $436.52 Typical High $1,778.28 | Facility | None | $346.74 | $436.52 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $870.96 | Professional | None | $346.74 | $346.74 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $346.74 Median $457.09 Typical High $870.96 | Facility | None | $346.74 | $457.09 | $870.96 |
Blue Shield Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | None | $346.74 | $346.74 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $457.09 | Professional | None | $204.17 | $380.19 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $234.42 Typical High $316.23 | Facility | None | $131.83 | $234.42 | $316.23 |
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 $346.74 Median $380.19 Typical High $457.09 | Professional | None | $346.74 | $380.19 | $457.09 |
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 $1,148.15 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,148.15 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $436.52 | Facility | None | $131.83 | $269.15 | $436.52 |
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 $398.11 | Professional | None | $125.89 | $125.89 | $398.11 |
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 $173.78 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $69.18 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $34.67 | $35.48 | $35.48 |
Where California sits
The same service costs 5.9 times more in Wyoming than in North Carolina. 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· 20th of 51
$347
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.