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 $912.01 Median $912.01 Typical High $933.25 | Facility | None | $912.01 | $912.01 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | None | $912.01 | $933.25 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $4,677.35 | Facility | None | $891.25 | $1,122.02 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,737.80 | Professional | None | $912.01 | $912.01 | $1,737.80 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $562.34 Typical High $1,258.93 | Facility | None | $100.00 | $562.34 | $1,258.93 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $1,174.90 Typical High $1,862.09 | Professional | None | $245.47 | $1,174.90 | $1,862.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $489.78 Typical High $588.84 | Professional | None | $204.17 | $489.78 | $588.84 |
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 $489.78 Median $912.01 Typical High $1,096.48 | Professional | None | $489.78 | $912.01 | $1,096.48 |
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 $3,019.95 Median $3,019.95 Typical High $3,890.45 | Professional | None | $3,019.95 | $3,019.95 | $3,890.45 |
Molina Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $933.25 | Facility | None | $131.83 | $269.15 | $933.25 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $93.33 |
Where California sits
The same service costs 12.0 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· 9th of 51
$912
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.