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 $46.77 Median $50.12 Typical High $53.70 | Facility | None | $46.77 | $50.12 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $63.10 | Professional | None | $40.74 | $51.29 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $48.98 Median $63.10 Typical High $257.04 | Facility | None | $48.98 | $63.10 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $257.04 | Professional | None | $50.12 | $54.95 | $257.04 |
Blue Shield Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $147.91 | Professional | None | $51.29 | $79.43 | $147.91 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $31.62 Median $40.74 Typical High $51.29 | Professional | None | $31.62 | $40.74 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $107.15 | Professional | None | $47.86 | $54.95 | $107.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | None | $20.89 | $20.89 | $25.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $32.36 Median $50.12 Typical High $120.23 | Professional | None | $32.36 | $50.12 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $54.95 | Professional | None | $32.36 | $32.36 | $54.95 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $107.15 | Facility | None | $43.65 | $64.57 | $107.15 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $112.20 | Professional | None | $47.86 | $54.95 | $112.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $107.15 | Professional | None | $39.81 | $51.29 | $107.15 |
3 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 $19.50 Median $23.44 Typical High $26.92 | Professional | 52 · Reduced service | $19.50 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $6.92 Typical High $7.94 | Professional | 55 · Aftercare only | $5.89 | $6.92 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.68 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $4.68 | $5.37 |
Where California sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 20th of 51
$56.23
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.