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 $87.10 Median $87.10 Typical High $89.13 | Facility | None | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | None | $87.10 | $89.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $457.09 | Facility | None | $85.11 | $109.65 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $208.93 | Professional | None | $87.10 | $87.10 | $208.93 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $134.90 Typical High $239.88 | Facility | None | $100.00 | $134.90 | $239.88 |
Blue Shield Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $457.09 | Professional | None | $239.88 | $288.40 | $457.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $204.17 | Professional | None | $95.50 | $95.50 | $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 $87.10 Median $97.72 Typical High $114.82 | Professional | None | $87.10 | $97.72 | $114.82 |
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 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $302.00 | Facility | None | $87.10 | $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 $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $43.65 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $43.65 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.71 | $8.91 | $8.91 |
Where California sits
The same service costs 1.9 times more in Alaska than in New York. 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· 25th 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.