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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $478.63 | Facility | None | $151.36 | $234.42 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $346.74 | Professional | None | $141.25 | $144.54 | $346.74 |
Blue Shield Setting Facility Modifier None Typical Low $77.62 Median $162.18 Typical High $269.15 | Facility | None | $77.62 | $162.18 | $269.15 |
Blue Shield Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $389.05 | Professional | None | $138.04 | $165.96 | $389.05 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $204.17 | Professional | None | $123.03 | $151.36 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $457.09 | Facility | None | $173.78 | $257.04 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $380.19 | Professional | None | $123.03 | $169.82 | $380.19 |
Molina Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $436.52 | Facility | None | $141.25 | $239.88 | $436.52 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | None | $138.04 | $181.97 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $398.11 | Facility | None | $138.04 | $138.04 | $398.11 |
United Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $398.11 | Professional | None | $158.49 | $169.82 | $398.11 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where California sits
The same service costs 1.8 times more in Arizona than in Rhode Island. 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· 13th of 51
$182
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.