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 $28.18 Median $29.51 Typical High $33.88 | Facility | None | $28.18 | $29.51 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $33.88 | Professional | None | $25.12 | $28.18 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $28.18 Typical High $31.62 | Facility | None | $26.30 | $28.18 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.44 Median $27.54 Typical High $89.13 | Professional | None | $23.44 | $27.54 | $89.13 |
Blue Shield Setting Facility Modifier None Typical Low $60.26 Median $275.42 Typical High $457.09 | Facility | None | $60.26 | $275.42 | $457.09 |
Blue Shield Setting Professional Modifier None Typical Low $21.88 Median $31.62 Typical High $45.71 | Professional | None | $21.88 | $31.62 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $138.04 Typical High $478.63 | Facility | None | $32.36 | $138.04 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $64.57 | Professional | None | $26.92 | $40.74 | $64.57 |
Contra Costa Health Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $51.29 | Professional | None | $38.02 | $41.69 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $33.88 Typical High $70.79 | Professional | None | $26.92 | $33.88 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Molina Setting Professional Modifier None Typical Low $11.48 Median $36.31 Typical High $38.90 | Professional | None | $11.48 | $36.31 | $38.90 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $70.79 | Professional | None | $30.90 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $138.04 | Facility | None | $28.18 | $43.65 | $138.04 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $41.69 Typical High $64.57 | Professional | None | $26.92 | $41.69 | $64.57 |
Sutter Health Plus Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $338.84 | Facility | None | $218.78 | $218.78 | $338.84 |
United Setting Professional Modifier None Typical Low $19.95 Median $34.67 Typical High $56.23 | Professional | None | $19.95 | $34.67 | $56.23 |
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 $12.59 Median $14.13 Typical High $16.98 | Professional | 52 · Reduced service | $12.59 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.62 Typical High $6.76 | Professional | 53 · Discontinued | $5.01 | $5.62 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.27 Typical High $5.13 | Professional | 55 · Aftercare only | $3.80 | $4.27 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.82 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.51 | $2.82 | $3.39 |
Where California sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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· 33rd of 51
$32.36
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.