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 $4.90 Median $4.90 Typical High $24.55 | Facility | None | $4.90 | $4.90 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $4.90 | Professional | None | $4.17 | $4.90 | $4.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $4.47 Typical High $6.31 | Professional | None | $3.63 | $4.47 | $6.31 |
Blue Shield Setting Professional Modifier None Typical Low $3.02 Median $4.37 Typical High $10.00 | Professional | None | $3.02 | $4.37 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $3.72 Median $7.41 Typical High $11.22 | Facility | None | $3.72 | $7.41 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.08 Median $12.88 Typical High $19.05 | Professional | None | $7.08 | $12.88 | $19.05 |
Lucent Health Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $38.02 | Professional | None | $28.18 | $38.02 | $38.02 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Providence Setting Facility Modifier None Typical Low $3.72 Median $6.92 Typical High $12.02 | Facility | None | $3.72 | $6.92 | $12.02 |
Providence Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
United Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $18.20 | Professional | None | $2.82 | $3.98 | $18.20 |
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 $2.09 Median $2.45 Typical High $2.45 | Professional | 52 · Reduced service | $2.09 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.98 Typical High $0.98 | Professional | 53 · Discontinued | $0.83 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.63 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.49 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.42 | $0.49 | $0.49 |
Where California sits
The same service costs 4.6 times more in Ohio than in Hawaii. 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· 12th of 51
$4.90
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.