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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $28.18 | Professional | None | $19.50 | $21.38 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $23.99 Typical High $26.92 | Facility | None | $0.03 | $23.99 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $69.18 | Professional | None | $22.91 | $22.91 | $69.18 |
Blue Shield Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $53.70 | Facility | None | $19.50 | $21.88 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $57.54 | Professional | None | $21.88 | $25.12 | $57.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $18.20 Median $23.99 Typical High $27.54 | Professional | None | $18.20 | $23.99 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $42.66 Typical High $64.57 | Facility | None | $21.38 | $42.66 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $407.38 | Professional | None | $30.20 | $39.81 | $407.38 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $27.54 Typical High $57.54 | Facility | None | $20.42 | $27.54 | $57.54 |
Providence Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $69.18 | Facility | None | $14.13 | $14.13 | $69.18 |
United Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $57.54 | Professional | None | $22.91 | $27.54 | $57.54 |
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 $9.77 Median $9.77 Typical High $9.77 | Professional | 52 · Reduced service | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
Where California sits
The same service costs 2.0 times more in Alabama than in Connecticut. 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· 27th of 51
$22.91
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.