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 $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $371.54 | Professional | None | $181.97 | $213.80 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $676.08 | Professional | None | $173.78 | $208.93 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $281.84 | Facility | None | $208.93 | $245.47 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $229.09 Typical High $380.19 | Professional | None | $72.44 | $229.09 | $380.19 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $194.98 Typical High $275.42 | Facility | None | $74.13 | $194.98 | $275.42 |
Blue Shield Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $524.81 | Professional | None | $208.93 | $245.47 | $524.81 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $288.40 | Professional | None | $190.55 | $251.19 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $426.58 Typical High $645.65 | Facility | None | $213.80 | $426.58 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $407.38 | Professional | None | $234.42 | $245.47 | $407.38 |
Molina Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $281.84 Typical High $537.03 | Facility | None | $100.00 | $281.84 | $537.03 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $213.80 Typical High $213.80 | Professional | None | $77.62 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
United Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $512.86 | Professional | None | $204.17 | $229.09 | $512.86 |
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 $97.72 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $19.50 |
Where California sits
The same service costs 549.5 times more in Arizona 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· 4th of 51
$229
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.