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 $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $26.30 Typical High $109.65 | Facility | None | $20.89 | $26.30 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $36.31 | Professional | None | $21.38 | $21.38 | $36.31 |
Blue Shield Setting Facility Modifier None Typical Low $89.13 Median $1,047.13 Typical High $2,187.76 | Facility | None | $89.13 | $1,047.13 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $42.66 Typical High $64.57 | Facility | None | $21.38 | $42.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $831.76 | Professional | None | $120.23 | $141.25 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Providence Setting Facility Modifier None Typical Low $21.38 Median $29.51 Typical High $57.54 | Facility | None | $21.38 | $29.51 | $57.54 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $25.70 | Professional | None | $21.38 | $21.38 | $25.70 |
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 $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.09 |
Where California sits
The same service costs 1.7 times more in Alaska than in Hawaii. 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· 36th of 51
$21.38
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.