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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | None | $42.66 | $42.66 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $53.70 Typical High $58.88 | Facility | None | $0.03 | $53.70 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $91.20 | Professional | None | $50.12 | $50.12 | $91.20 |
Blue Shield Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $64.57 | Facility | None | $42.66 | $42.66 | $64.57 |
Blue Shield Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $125.89 | Professional | None | $47.86 | $56.23 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $85.11 | Professional | None | $53.70 | $53.70 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $407.38 | Professional | None | $74.13 | $102.33 | $407.38 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $117.49 | Facility | None | $42.66 | $61.66 | $117.49 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $85.11 | Professional | None | $53.70 | $58.88 | $85.11 |
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 $50.12 Median $60.26 Typical High $134.90 | Professional | None | $50.12 | $60.26 | $134.90 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where California sits
The same service costs 2.0 times more in Oregon than in Alabama. 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· 28th of 51
$50.12
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.