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 $19.95 Median $19.95 Typical High $30.90 | Facility | None | $19.95 | $19.95 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $38.90 | Professional | None | $19.95 | $21.88 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $33.11 Typical High $74.13 | Facility | None | $22.39 | $33.11 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $48.98 | Professional | None | $19.95 | $23.44 | $48.98 |
Blue Shield Setting Facility Modifier None Typical Low $19.95 Median $23.44 Typical High $48.98 | Facility | None | $19.95 | $23.44 | $48.98 |
Blue Shield Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $58.88 | Professional | None | $22.39 | $26.30 | $58.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $33.88 | Professional | None | $22.39 | $28.84 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $44.67 Typical High $67.61 | Facility | None | $21.88 | $44.67 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $23.99 Median $30.20 Typical High $407.38 | Professional | None | $23.99 | $30.20 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Providence Setting Facility Modifier None Typical Low $20.89 Median $28.84 Typical High $58.88 | Facility | None | $20.89 | $28.84 | $58.88 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
United Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $64.57 | Facility | None | $20.42 | $20.42 | $64.57 |
United Setting Professional Modifier None Typical Low $23.44 Median $26.92 Typical High $58.88 | Professional | None | $23.44 | $26.92 | $58.88 |
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 $10.00 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.00 |
Where California sits
The same service costs 1.9 times more in Alabama 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
$23.99
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.