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 Professional Modifier None Typical Low $6.61 Median $7.24 Typical High $7.24 | Professional | None | $6.61 | $7.24 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.13 | Professional | None | $5.01 | $5.01 | $5.13 |
Blue Shield Setting Professional Modifier None Typical Low $4.57 Median $6.61 Typical High $6.76 | Professional | None | $4.57 | $6.61 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $131.83 Typical High $162.18 | Professional | None | $27.54 | $131.83 | $162.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $23.99 | Professional | None | $19.95 | $19.95 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $831.76 | Professional | None | $28.84 | $60.26 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $37.15 | Professional | None | $6.61 | $6.61 | $37.15 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $79.43 | Professional | None | $5.01 | $5.01 | $79.43 |
5 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 $3.31 Median $3.63 Typical High $3.63 | Professional | 52 · Reduced service | $3.31 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.45 Typical High $1.45 | Professional | 53 · Discontinued | $1.32 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.00 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.66 | $0.72 | $0.72 |
Providence Setting Professional Modifier HO · Master's level Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | HO · Master's level | $5.01 | $5.01 | $5.01 |
Where California sits
The same service costs 125892.5 times more in Massachusetts than in New York. 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· 45th of 51
$6.61
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.