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 $85.11 Median $97.72 Typical High $117.49 | Facility | None | $85.11 | $97.72 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $107.15 | Professional | None | $77.62 | $93.33 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.75 Median $3.47 Typical High $14.45 | Facility | None | $2.75 | $3.47 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $407.38 | Professional | None | $87.10 | $138.04 | $407.38 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $194.98 | Professional | None | $109.65 | $154.88 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $154.88 | Professional | None | $85.11 | $109.65 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $194.98 | Professional | None | $74.13 | $112.20 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 Facility Modifier None Typical Low $77.62 Median $114.82 Typical High $173.78 | Facility | None | $77.62 | $114.82 | $173.78 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $154.88 | Professional | None | $85.11 | $109.65 | $154.88 |
United Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $162.18 | Professional | None | $69.18 | $100.00 | $162.18 |
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 $42.66 Median $48.98 Typical High $57.54 | Facility | 52 · Reduced service | $42.66 | $48.98 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $14.79 Typical High $17.38 | Facility | 55 · Aftercare only | $12.88 | $14.79 | $17.38 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.77 Typical High $11.75 | Facility | 56 · Pre-op care only | $8.51 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $38.90 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $10.72 |
Where California sits
The same service costs 2.5 times more in Alaska than in Florida. 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· 22nd of 51
$112
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.