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 $457.09 Median $457.09 Typical High $467.74 | Facility | None | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $467.74 | Professional | None | $457.09 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $2,398.83 | Facility | None | $446.68 | $575.44 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $870.96 | Professional | None | $457.09 | $457.09 | $870.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $933.25 Typical High $1,258.93 | Facility | None | $100.00 | $933.25 | $1,258.93 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $1,995.26 Typical High $3,090.30 | Professional | None | $245.47 | $1,995.26 | $3,090.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $204.17 | Professional | None | $107.15 | $107.15 | $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 $107.15 Median $457.09 Typical High $549.54 | Professional | None | $107.15 | $457.09 | $549.54 |
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 $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $489.78 | Facility | None | $131.83 | $269.15 | $489.78 |
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 $245.47 | Professional | None | $125.89 | $125.89 | $245.47 |
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 $229.09 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $46.77 | $46.77 |
Where California sits
The same service costs 12.0 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· 11th of 51
$457
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.