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 $707.95 Median $707.95 Typical High $724.44 | Facility | None | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | None | $707.95 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $891.25 Typical High $3,630.78 | Facility | None | $691.83 | $891.25 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,348.96 | Professional | None | $707.95 | $707.95 | $1,348.96 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,288.25 Typical High $2,454.71 | Facility | None | $100.00 | $1,288.25 | $2,454.71 |
Blue Shield Setting Professional Modifier None Typical Low $245.47 Median $2,691.53 Typical High $4,265.80 | Professional | None | $245.47 | $2,691.53 | $4,265.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $204.17 Median $1,288.25 Typical High $1,548.82 | Professional | None | $204.17 | $1,288.25 | $1,548.82 |
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 $707.95 Median $776.25 Typical High $1,288.25 | Professional | None | $707.95 | $776.25 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $446.68 | Professional | None | $134.90 | $165.96 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $3,548.13 | Professional | None | $2,454.71 | $2,511.89 | $3,548.13 |
Molina Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $758.58 | Facility | None | $131.83 | $269.15 | $758.58 |
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 $977.24 | Professional | None | $125.89 | $125.89 | $977.24 |
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 $354.81 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $354.81 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $70.79 | $72.44 | $72.44 |
Where California sits
The same service costs 13.2 times more in Hawaii 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· 22nd of 51
$708
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.