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 $44.67 Median $44.67 Typical High $81.28 | Facility | None | $44.67 | $44.67 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $47.86 Typical High $66.07 | Facility | None | $32.36 | $47.86 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $60.26 | Professional | None | $31.62 | $32.36 | $60.26 |
Blue Shield Setting Facility Modifier None Typical Low $26.30 Median $87.10 Typical High $109.65 | Facility | None | $26.30 | $87.10 | $109.65 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $67.61 | Professional | None | $44.67 | $57.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $91.20 Typical High $138.04 | Facility | None | $45.71 | $91.20 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $81.28 Typical High $138.04 | Facility | None | $44.67 | $81.28 | $138.04 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | None | $107.15 | $173.78 | $173.78 |
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 $22.39 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
Where California sits
The same service costs 17.8 times more in Alabama than in North Dakota. 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· 42nd of 51
$44.67
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.