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 $446.68 Median $446.68 Typical High $457.09 | Facility | None | $446.68 | $446.68 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | None | $446.68 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $549.54 Typical High $2,290.87 | Facility | None | $436.52 | $549.54 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $1,230.27 | Professional | None | $446.68 | $446.68 | $1,230.27 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $489.78 Typical High $1,230.27 | Facility | None | $100.00 | $489.78 | $1,230.27 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $1,023.29 Typical High $1,621.81 | Professional | None | $245.47 | $1,023.29 | $1,621.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $616.60 Typical High $741.31 | Professional | None | $204.17 | $616.60 | $741.31 |
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 |
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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $478.63 | Facility | None | $131.83 | $269.15 | $478.63 |
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 $660.69 | Professional | None | $125.89 | $125.89 | $660.69 |
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 $223.87 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $89.13 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $44.67 | $45.71 | $45.71 |
Where California sits
The same service costs 10.0 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· 23rd of 51
$447
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.