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 $69.18 Median $79.43 Typical High $93.33 | Facility | None | $69.18 | $79.43 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $107.15 | Professional | None | $66.07 | $81.28 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $457.09 | Facility | None | $85.11 | $109.65 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $204.17 | Professional | None | $79.43 | $89.13 | $204.17 |
Blue Shield Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $91.20 | Professional | None | $54.95 | $77.62 | $91.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $42.66 | Professional | None | $34.67 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $154.88 | Professional | None | $67.61 | $83.18 | $154.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $102.33 | Professional | None | $34.67 | $42.66 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $251.19 | Professional | None | $66.07 | $85.11 | $251.19 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $87.10 Typical High $125.89 | Facility | None | $56.23 | $87.10 | $125.89 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $107.15 | Professional | None | $69.18 | $81.28 | $107.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $346.74 | Professional | None | $64.57 | $79.43 | $346.74 |
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 Facility Modifier 52 · Reduced service Typical Low $37.15 Median $39.81 Typical High $42.66 | Facility | 52 · Reduced service | $37.15 | $39.81 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $12.02 Typical High $12.88 | Facility | 55 · Aftercare only | $10.96 | $12.02 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $8.51 | Facility | 56 · Pre-op care only | $7.41 | $7.94 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $37.15 Typical High $42.66 | Professional | 52 · Reduced service | $31.62 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.96 Typical High $12.88 | Professional | 55 · Aftercare only | $9.55 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $8.51 |
Where California sits
The same service costs 2.1 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· 23rd of 51
$85.11
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.