How much rates vary
Facilitymedian $1,445 · 10th to 90th $166 to $2,884Professionalmedian $1,445 · 10th to 90th $126 to $4,786
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 $1,445.44 Median $1,445.44 Typical High $1,479.11 | Facility | None | $1,445.44 | $1,445.44 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $7,413.10 | Facility | None | $1,412.54 | $1,778.28 | $7,413.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,445.44 | $2,818.38 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $933.25 Typical High $4,168.69 | Facility | None | $100.00 | $933.25 | $4,168.69 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $1,949.84 Typical High $3,090.30 | Professional | None | $245.47 | $1,949.84 | $3,090.30 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $1,548.82 Typical High $1,862.09 | Professional | None | $204.17 | $1,548.82 | $1,862.09 |
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 $1,445.44 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,584.89 | $1,862.09 |
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 $4,786.30 Median $4,786.30 Typical High $6,456.54 | Professional | None | $4,786.30 | $4,786.30 | $6,456.54 |
Molina Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $1,548.82 | Facility | None | $131.83 | $269.15 | $1,548.82 |
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 $346.74 | Professional | None | $125.89 | $125.89 | $346.74 |
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 $724.44 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $724.44 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $147.91 | $147.91 |
Where California sits
The same service costs 21.9 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· 16th of 51
$1,445
WY $2,570NC $117
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.