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 $3,019.95 Median $3,019.95 Typical High $3,019.95 | Facility | None | $3,019.95 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $660.69 Typical High $2,754.23 | Facility | None | $512.86 | $660.69 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,202.26 | Professional | None | $524.81 | $524.81 | $1,202.26 |
Blue Shield Setting Professional Modifier None Typical Low $100.00 Median $263.03 Typical High $758.58 | Professional | None | $100.00 | $263.03 | $758.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $524.81 Typical High $630.96 | Professional | None | $204.17 | $524.81 | $630.96 |
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 $177.83 Median $199.53 Typical High $524.81 | Professional | None | $177.83 | $199.53 | $524.81 |
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 $10,964.78 Median $10,964.78 Typical High $16,595.87 | Professional | None | $10,964.78 | $10,964.78 | $16,595.87 |
Molina Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $3,019.95 | Facility | None | $131.83 | $269.15 | $3,019.95 |
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 $524.81 | Professional | None | $125.89 | $125.89 | $524.81 |
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 $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $302.00 |
Where California sits
The same service costs 26.9 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· 20th of 51
$525
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.