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 $15.49 Median $16.22 Typical High $19.50 | Facility | None | $15.49 | $16.22 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $16.22 Typical High $20.89 | Professional | None | $13.49 | $16.22 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $15.85 Typical High $66.07 | Facility | None | $12.59 | $15.85 | $66.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $24.55 | Professional | None | $12.88 | $12.88 | $24.55 |
Blue Shield Setting Facility Modifier None Typical Low $22.39 Median $33.88 Typical High $52.48 | Facility | None | $22.39 | $33.88 | $52.48 |
Blue Shield Setting Professional Modifier None Typical Low $5.50 Median $7.76 Typical High $10.96 | Professional | None | $5.50 | $7.76 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Contra Costa Health Setting Professional Modifier None Typical Low $14.45 Median $20.89 Typical High $22.91 | Professional | None | $14.45 | $20.89 | $22.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.88 Median $17.78 Typical High $28.18 | Professional | None | $12.88 | $17.78 | $28.18 |
Lucent Health Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | None | $107.15 | $107.15 | $144.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $15.14 Median $18.62 Typical High $25.70 | Facility | None | $15.14 | $18.62 | $25.70 |
Providence Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Sutter Health Plus Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $56.23 | Professional | None | $52.48 | $52.48 | $56.23 |
United Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
United Setting Professional Modifier None Typical Low $11.75 Median $14.45 Typical High $26.30 | Professional | None | $11.75 | $14.45 | $26.30 |
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 $6.76 Median $8.13 Typical High $10.47 | Professional | 52 · Reduced service | $6.76 | $8.13 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.24 Typical High $4.17 | Professional | 53 · Discontinued | $2.69 | $3.24 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.45 Typical High $3.16 | Professional | 55 · Aftercare only | $2.00 | $2.45 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.62 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.35 | $1.62 | $2.09 |
Where California sits
The same service costs 3.2 times more in Alaska than in New York. 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
$14.79
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.