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 $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.80 Typical High $29.51 | Professional | None | $3.02 | $3.80 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $18.62 Typical High $75.86 | Facility | None | $14.45 | $18.62 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $23.44 Typical High $42.66 | Professional | None | $14.79 | $23.44 | $42.66 |
Blue Shield Setting Facility Modifier None Typical Low $38.90 Median $57.54 Typical High $208.93 | Facility | None | $38.90 | $57.54 | $208.93 |
Blue Shield Setting Professional Modifier None Typical Low $19.50 Median $28.18 Typical High $48.98 | Professional | None | $19.50 | $28.18 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $24.55 Typical High $33.11 | Professional | None | $8.51 | $24.55 | $33.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $17.78 Median $22.91 Typical High $60.26 | Professional | None | $17.78 | $22.91 | $60.26 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Providence Setting Facility Modifier None Typical Low $3.02 Median $11.48 Typical High $33.88 | Facility | None | $3.02 | $11.48 | $33.88 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $20.42 Typical High $38.90 | Professional | None | $8.51 | $20.42 | $38.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $181.97 | Facility | None | $117.49 | $117.49 | $181.97 |
United Setting Professional Modifier None Typical Low $11.22 Median $17.38 Typical High $61.66 | Professional | None | $11.22 | $17.38 | $61.66 |
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 $1.51 Median $1.51 Typical High $2.00 | Professional | 52 · Reduced service | $1.51 | $1.51 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.79 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.60 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.40 |
Where California sits
The same service costs 5.2 times more in Texas than in Kentucky. 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· 21st of 51
$20.42
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.