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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | None | $67.61 | $67.61 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $83.18 Typical High $93.33 | Facility | None | $0.03 | $83.18 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $131.83 | Professional | None | $14.45 | $79.43 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $66.07 Median $70.79 Typical High $100.00 | Facility | None | $66.07 | $70.79 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $190.55 | Professional | None | $75.86 | $87.10 | $190.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $97.72 | Professional | None | $64.57 | $83.18 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $147.91 Typical High $223.87 | Facility | None | $74.13 | $147.91 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $407.38 | Professional | None | $56.23 | $79.43 | $407.38 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $95.50 Typical High $186.21 | Facility | None | $25.12 | $95.50 | $186.21 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $74.13 Typical High $74.13 | Professional | None | $21.88 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $177.83 | Professional | None | $72.44 | $79.43 | $177.83 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where California sits
The same service costs 6.5 times more in Arizona than in Hawaii. 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· 4th of 51
$79.43
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.