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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $15,135.61 | Facility | None | $2,884.03 | $3,630.78 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $6,165.95 | Professional | None | $2,951.21 | $2,951.21 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $4,265.80 | Professional | None | $100.00 | $100.00 | $4,265.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,951.21 | $2,951.21 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $8,128.31 Typical High $12,589.25 | Facility | None | $4,073.80 | $8,128.31 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,951.21 | $2,951.21 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $2,137.96 Typical High $5,011.87 | Professional | None | $128.82 | $2,137.96 | $5,011.87 |
Lucent Health Setting Professional Modifier None Typical Low $21,877.62 Median $21,877.62 Typical High $21,877.62 | Professional | None | $21,877.62 | $21,877.62 | $21,877.62 |
Molina Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $2,951.21 Median $5,754.40 Typical High $10,964.78 | Facility | None | $2,951.21 | $5,754.40 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Professional | None | $4,073.80 | $4,073.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $5,011.87 | Professional | None | $3,715.35 | $4,168.69 | $5,011.87 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $398.11 |
Where California sits
The same service costs 2.2 times more in Alaska than in South 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· 12th of 51
$4,074
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.