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 $29.51 Median $32.36 Typical High $40.74 | Facility | None | $29.51 | $32.36 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $40.74 | Professional | None | $29.51 | $32.36 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $40.74 Typical High $169.82 | Facility | None | $32.36 | $40.74 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $50.12 | Professional | None | $26.92 | $26.92 | $50.12 |
Blue Shield Setting Facility Modifier None Typical Low $54.95 Median $93.33 Typical High $169.82 | Facility | None | $54.95 | $93.33 | $169.82 |
Blue Shield Setting Professional Modifier None Typical Low $7.24 Median $20.42 Typical High $33.11 | Professional | None | $7.24 | $20.42 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $66.07 | Professional | None | $54.95 | $60.26 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $107.15 | Professional | None | $37.15 | $52.48 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | None | $269.15 | $269.15 | $346.74 |
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 $32.36 Median $45.71 Typical High $66.07 | Facility | None | $32.36 | $45.71 | $66.07 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $93.33 | Facility | None | $61.66 | $61.66 | $93.33 |
United Setting Professional Modifier None Typical Low $24.55 Median $35.48 Typical High $70.79 | Professional | None | $24.55 | $35.48 | $70.79 |
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 $14.79 Median $16.22 Typical High $20.42 | Professional | 52 · Reduced service | $14.79 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.46 Typical High $8.13 | Professional | 53 · Discontinued | $5.89 | $6.46 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.79 Typical High $6.03 | Professional | 55 · Aftercare only | $4.47 | $4.79 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.24 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.95 | $3.24 | $4.07 |
Where California sits
The same service costs 12.9 times more in Hawaii than in Kentucky. 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· 49th of 51
$33.11
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.