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 $549.54 Median $549.54 Typical High $562.34 | Facility | None | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $562.34 | Professional | None | $549.54 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $2,818.38 | Facility | None | $537.03 | $691.83 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,380.38 | Professional | None | $549.54 | $549.54 | $1,380.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $549.54 Typical High $630.96 | Facility | None | $100.00 | $549.54 | $630.96 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $1,148.15 Typical High $1,819.70 | Professional | None | $245.47 | $1,148.15 | $1,819.70 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $309.03 | Professional | None | $204.17 | $257.04 | $309.03 |
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 $257.04 Median $549.54 Typical High $660.69 | Professional | None | $257.04 | $549.54 | $660.69 |
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 $1,819.70 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,819.70 | $1,819.70 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $575.44 | Facility | None | $131.83 | $269.15 | $575.44 |
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 $512.86 | Professional | None | $125.89 | $125.89 | $512.86 |
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 $275.42 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $56.23 |
Where California sits
The same service costs 9.1 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· 9th of 51
$550
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.