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 $30.90 Median $33.11 Typical High $33.11 | Facility | None | $30.90 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $30.90 Typical High $34.67 | Professional | None | $28.84 | $30.90 | $34.67 |
Blue Shield Setting Professional Modifier None Typical Low $25.12 Median $35.48 Typical High $39.81 | Professional | None | $25.12 | $35.48 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $41.69 | Professional | None | $34.67 | $38.90 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $57.54 | Professional | None | $30.20 | $33.88 | $57.54 |
Lucent Health Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | None | $213.80 | $275.42 | $275.42 |
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 $33.11 Median $40.74 Typical High $48.98 | Facility | None | $33.11 | $40.74 | $48.98 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Sutter Health Plus Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
United Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $51.29 | Professional | None | $27.54 | $35.48 | $51.29 |
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 $14.45 Median $15.49 Typical High $17.38 | Professional | 52 · Reduced service | $14.45 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.17 Typical High $6.92 | Professional | 53 · Discontinued | $5.75 | $6.17 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.68 Typical High $5.13 | Professional | 55 · Aftercare only | $4.37 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.09 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.88 | $3.09 | $3.47 |
Where California sits
The same service costs 3.0 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· 24th of 51
$35.48
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.