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 $42.66 Median $45.71 Typical High $56.23 | Facility | None | $42.66 | $45.71 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $56.23 | Professional | None | $39.81 | $45.71 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $234.42 | Facility | None | $45.71 | $57.54 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $70.79 | Professional | None | $36.31 | $36.31 | $70.79 |
Blue Shield Setting Facility Modifier None Typical Low $47.86 Median $112.20 Typical High $213.80 | Facility | None | $47.86 | $112.20 | $213.80 |
Blue Shield Setting Professional Modifier None Typical Low $19.95 Median $33.88 Typical High $53.70 | Professional | None | $19.95 | $33.88 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | None | $85.11 | $93.33 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $165.96 | Professional | None | $58.88 | $83.18 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $549.54 | Professional | None | $398.11 | $398.11 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $66.07 Typical High $107.15 | Facility | None | $45.71 | $66.07 | $107.15 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Sutter Health Plus Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $72.44 | Facility | None | $47.86 | $47.86 | $72.44 |
United Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $95.50 | Professional | None | $35.48 | $46.77 | $95.50 |
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 $19.95 Median $22.91 Typical High $28.18 | Professional | 52 · Reduced service | $19.95 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.12 Typical High $11.22 | Professional | 53 · Discontinued | $7.94 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.76 Typical High $8.32 | Professional | 55 · Aftercare only | $6.03 | $6.76 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.57 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.98 | $4.57 | $5.62 |
Where California sits
The same service costs 2.6 times more in Alaska than in Utah. 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· 46th of 51
$48.98
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.