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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $52.48 | Professional | None | $32.36 | $35.48 | $52.48 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $39.81 Typical High $46.77 | Facility | None | $33.88 | $39.81 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | None | $38.02 | $38.02 | $72.44 |
Blue Shield Setting Facility Modifier None Typical Low $31.62 Median $33.11 Typical High $46.77 | Facility | None | $31.62 | $33.11 | $46.77 |
Blue Shield Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $89.13 | Professional | None | $35.48 | $41.69 | $89.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $45.71 | Professional | None | $30.90 | $39.81 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $70.79 Typical High $107.15 | Facility | None | $35.48 | $70.79 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $61.66 Typical High $407.38 | Professional | None | $44.67 | $61.66 | $407.38 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $46.77 Typical High $93.33 | Facility | None | $32.36 | $46.77 | $93.33 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $35.48 Typical High $35.48 | Professional | None | $30.20 | $35.48 | $35.48 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $85.11 | Professional | None | $34.67 | $37.15 | $85.11 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where California sits
The same service costs 97.7 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· 8th of 51
$38.02
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.