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 $47.86 Median $51.29 Typical High $51.29 | Facility | None | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $53.70 | Professional | None | $44.67 | $47.86 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $60.26 | Professional | None | $38.90 | $54.95 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $64.57 | Professional | None | $53.70 | $60.26 | $64.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $91.20 | Professional | None | $46.77 | $52.48 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $446.68 | Professional | None | $331.13 | $446.68 | $446.68 |
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 $51.29 Median $63.10 Typical High $75.86 | Facility | None | $51.29 | $63.10 | $75.86 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $79.43 | Professional | None | $41.69 | $54.95 | $79.43 |
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 $22.39 Median $23.99 Typical High $26.92 | Professional | 52 · Reduced service | $22.39 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $9.55 Typical High $10.72 | Professional | 53 · Discontinued | $8.91 | $9.55 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $7.24 Typical High $7.94 | Professional | 55 · Aftercare only | $6.76 | $7.24 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.79 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.47 | $4.79 | $5.37 |
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
$54.95
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.