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 $34.67 Median $39.81 Typical High $512.86 | Facility | None | $34.67 | $39.81 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $51.29 | Professional | None | $33.11 | $35.48 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $34.67 Typical High $3,890.45 | Facility | None | $26.30 | $34.67 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $27.54 Typical High $107.15 | Professional | None | $26.92 | $27.54 | $107.15 |
Blue Shield Setting Facility Modifier None Typical Low $95.50 Median $147.91 Typical High $602.56 | Facility | None | $95.50 | $147.91 | $602.56 |
Blue Shield Setting Professional Modifier None Typical Low $14.79 Median $20.89 Typical High $30.20 | Professional | None | $14.79 | $20.89 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $104.71 | Professional | None | $25.70 | $38.90 | $104.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $407.38 | Professional | None | $53.70 | $87.10 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | None | $575.44 | $575.44 | $758.58 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $724.44 | Professional | None | $40.74 | $40.74 | $724.44 |
Providence Setting Facility Modifier None Typical Low $12.02 Median $34.67 Typical High $112.20 | Facility | None | $12.02 | $34.67 | $112.20 |
Providence Setting Professional Modifier None Typical Low $25.70 Median $38.90 Typical High $104.71 | Professional | None | $25.70 | $38.90 | $104.71 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Facility | None | $331.13 | $331.13 | $501.19 |
United Setting Professional Modifier None Typical Low $33.88 Median $85.11 Typical High $147.91 | Professional | None | $33.88 | $85.11 | $147.91 |
6 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 $15.85 Median $17.38 Typical High $19.95 | Professional | 52 · Reduced service | $15.85 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.92 Typical High $7.94 | Professional | 53 · Discontinued | $6.31 | $6.92 | $7.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $25.70 Typical High $29.51 | Professional | 54 · Surgery only | $23.99 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.13 Typical High $6.03 | Professional | 55 · Aftercare only | $4.79 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.47 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.16 | $3.47 | $3.98 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 59 · Distinct service | $4.47 | $4.47 | $4.47 |
Where California sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 48th of 51
$36.31
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.