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 $79.43 Median $79.43 Typical High $81.28 | Facility | None | $79.43 | $79.43 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | None | $79.43 | $81.28 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $407.38 | Facility | None | $79.43 | $100.00 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $186.21 | Professional | None | $79.43 | $79.43 | $186.21 |
Blue Shield Setting Facility Modifier None Typical Low $91.20 Median $1,047.13 Typical High $2,187.76 | Facility | None | $91.20 | $1,047.13 | $2,187.76 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $1,318.26 Typical High $2,089.30 | Professional | None | $245.47 | $1,318.26 | $2,089.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $630.96 Typical High $741.31 | Professional | None | $204.17 | $630.96 | $741.31 |
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 $79.43 Median $87.10 Typical High $630.96 | Professional | None | $79.43 | $87.10 | $630.96 |
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 $1,174.90 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,174.90 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $79.43 Median $190.55 Typical High $302.00 | Facility | None | $79.43 | $190.55 | $302.00 |
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 Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $346.74 | Professional | None | $125.89 | $125.89 | $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 $39.81 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $39.81 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $8.13 |
Where California sits
The same service costs 7.2 times more in Hawaii 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.