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 $87.10 Median $91.20 Typical High $109.65 | Facility | None | $87.10 | $91.20 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $177.83 | Professional | None | $87.10 | $100.00 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.82 Median $3.63 Typical High $14.79 | Facility | None | $2.82 | $3.63 | $14.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $478.63 | Professional | None | $114.82 | $158.49 | $478.63 |
Blue Shield Setting Professional Modifier None Typical Low $77.62 Median $107.15 Typical High $123.03 | Professional | None | $77.62 | $107.15 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | None | $102.33 | $102.33 | $144.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $144.54 | Professional | None | $107.15 | $131.83 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $354.81 | Professional | None | $102.33 | $120.23 | $354.81 |
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 $39.81 Median $120.23 Typical High $165.96 | Facility | None | $39.81 | $120.23 | $165.96 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $537.03 | Professional | None | $81.28 | $102.33 | $537.03 |
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 $42.66 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $42.66 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $21.88 | Professional | 53 · Discontinued | $16.98 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $10.96 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $10.96 |
Where California sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 36th of 51
$107
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.