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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $91.20 | Professional | None | $46.77 | $54.95 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $54.95 Typical High $173.78 | Professional | None | $51.29 | $54.95 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $60.26 Typical High $70.79 | Facility | None | $51.29 | $60.26 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $104.71 | Professional | None | $30.90 | $57.54 | $104.71 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $50.12 Typical High $72.44 | Facility | None | $48.98 | $50.12 | $72.44 |
Blue Shield Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $134.90 | Professional | None | $54.95 | $63.10 | $134.90 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $70.79 | Professional | None | $46.77 | $61.66 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $107.15 Typical High $162.18 | Facility | None | $53.70 | $107.15 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $407.38 | Professional | None | $57.54 | $70.79 | $407.38 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $72.44 Typical High $141.25 | Facility | None | $38.90 | $72.44 | $141.25 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $53.70 Typical High $53.70 | Professional | None | $30.20 | $53.70 | $53.70 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $128.82 | Professional | None | $52.48 | $54.95 | $128.82 |
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 $25.70 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 53 · Discontinued | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $5.13 |
Where California sits
The same service costs 1.5 times more in Colorado than in Alaska. 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· 2nd of 51
$57.54
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.