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 $10.00 Median $12.30 Typical High $20.42 | Facility | None | $10.00 | $12.30 | $20.42 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $13.49 Typical High $51.29 | Professional | None | $9.77 | $13.49 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $33.88 Typical High $138.04 | Facility | None | $26.92 | $33.88 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $26.92 Typical High $39.81 | Professional | None | $14.13 | $26.92 | $39.81 |
Blue Shield Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $128.82 | Facility | None | $38.02 | $57.54 | $128.82 |
Blue Shield Setting Professional Modifier None Typical Low $8.51 Median $12.88 Typical High $28.84 | Professional | None | $8.51 | $12.88 | $28.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $23.44 Median $26.30 Typical High $32.36 | Professional | None | $23.44 | $26.30 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $112.20 | Professional | None | $33.88 | $43.65 | $112.20 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $14.45 Typical High $33.11 | Facility | None | $10.00 | $14.45 | $33.11 |
Providence Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $117.49 | Facility | None | $77.62 | $77.62 | $117.49 |
United Setting Professional Modifier None Typical Low $14.45 Median $26.30 Typical High $72.44 | Professional | None | $14.45 | $26.30 | $72.44 |
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 $4.90 Median $5.01 Typical High $6.17 | Professional | 52 · Reduced service | $4.90 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.04 Typical High $2.45 | Professional | 53 · Discontinued | $1.95 | $2.04 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.51 Typical High $1.86 | Professional | 55 · Aftercare only | $1.48 | $1.51 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $1.00 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.98 | $1.00 | $1.23 |
Where California sits
The same service costs 4.6 times more in Alabama than in Missouri. 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· 26th of 51
$26.92
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.