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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | None | $66.07 | $70.79 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $109.65 Typical High $269.15 | Facility | None | $74.13 | $109.65 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $177.83 | Professional | None | $74.13 | $81.28 | $177.83 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $69.18 Typical High $100.00 | Facility | None | $64.57 | $69.18 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $194.98 | Professional | None | $74.13 | $87.10 | $194.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $97.72 | Professional | None | $64.57 | $85.11 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $144.54 Typical High $218.78 | Facility | None | $72.44 | $144.54 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $436.52 | Professional | None | $169.82 | $234.42 | $436.52 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $95.50 Typical High $194.98 | Facility | None | $69.18 | $95.50 | $194.98 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | None | $72.44 | $72.44 | $79.43 |
United Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $199.53 | Professional | None | $77.62 | $89.13 | $199.53 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $13.18 | $13.18 | $13.18 |
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 $6.61 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $6.61 |
Where California sits
The same service costs 2.8 times more in Arizona 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· 10th of 51
$81.28
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.