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 $77.62 | Facility | None | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $77.62 Typical High $77.62 | Professional | None | $75.86 | $77.62 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $389.05 | Facility | None | $75.86 | $95.50 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $204.17 | Professional | None | $75.86 | $75.86 | $204.17 |
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 $169.82 Median $263.03 Typical High $323.59 | Professional | None | $169.82 | $263.03 | $323.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $204.17 | Professional | None | $85.11 | $85.11 | $204.17 |
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 $75.86 Median $83.18 Typical High $102.33 | Professional | None | $75.86 | $83.18 | $102.33 |
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 $75.86 Median $190.55 Typical High $302.00 | Facility | None | $75.86 | $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 Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $177.83 | Professional | None | $125.89 | $125.89 | $177.83 |
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 $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.59 | $7.76 | $7.76 |
Where California sits
The same service costs 3.8 times more in Wyoming 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· 10th 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.