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 $12.88 Median $12.88 Typical High $70.79 | Facility | None | $12.88 | $12.88 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $14.79 | Professional | None | $12.88 | $12.88 | $14.79 |
Ambetter Setting Professional Modifier None Typical Low $21.38 Median $27.54 Typical High $269.15 | Professional | None | $21.38 | $27.54 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.18 Median $15.49 Typical High $19.50 | Facility | None | $13.18 | $15.49 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $25.12 | Professional | None | $13.18 | $13.18 | $25.12 |
Blue Shield Setting Professional Modifier None Typical Low $23.44 Median $33.11 Typical High $75.86 | Professional | None | $23.44 | $33.11 | $75.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $28.18 | Professional | None | $19.05 | $19.05 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $26.30 Typical High $39.81 | Facility | None | $13.18 | $26.30 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $14.79 Median $16.22 Typical High $19.95 | Professional | None | $14.79 | $16.22 | $19.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $15.14 Median $33.88 Typical High $57.54 | Professional | None | $15.14 | $33.88 | $57.54 |
Lucent Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Providence Setting Facility Modifier None Typical Low $13.18 Median $19.05 Typical High $35.48 | Facility | None | $13.18 | $19.05 | $35.48 |
Providence Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $14.79 | Professional | None | $13.18 | $13.18 | $14.79 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $34.67 | Professional | None | $12.88 | $12.88 | $34.67 |
4 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 $6.46 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Where California sits
The same service costs 11.0 times more in Kansas 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· 24th of 51
$14.13
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.