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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $33.88 Typical High $45.71 | Professional | None | $29.51 | $33.88 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $102.33 | Facility | None | $33.11 | $50.12 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $70.79 | Professional | None | $31.62 | $32.36 | $70.79 |
Blue Shield Setting Facility Modifier None Typical Low $26.30 Median $30.90 Typical High $46.77 | Facility | None | $26.30 | $30.90 | $46.77 |
Blue Shield Setting Professional Modifier None Typical Low $26.30 Median $31.62 Typical High $74.13 | Professional | None | $26.30 | $31.62 | $74.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $44.67 | Professional | None | $26.92 | $32.36 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $58.88 Typical High $89.13 | Facility | None | $29.51 | $58.88 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $35.48 Typical High $79.43 | Professional | None | $26.92 | $35.48 | $79.43 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $29.51 Median $43.65 Typical High $85.11 | Facility | None | $29.51 | $43.65 | $85.11 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $50.12 | Facility | None | $26.30 | $26.30 | $50.12 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $69.18 | Professional | None | $29.51 | $31.62 | $69.18 |
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 $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Where California sits
Rates are fairly even across states for this service. 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· 3rd of 51
$33.88
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.