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 $19.95 Median $20.42 Typical High $21.88 | Facility | None | $19.95 | $20.42 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.95 Typical High $21.88 | Professional | None | $18.62 | $19.95 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $27.54 Typical High $112.20 | Professional | None | $11.22 | $27.54 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $23.99 | Professional | None | $19.95 | $19.95 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.95 Median $407.38 Typical High $831.76 | Professional | None | $19.95 | $407.38 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $199.53 | Professional | None | $151.36 | $199.53 | $199.53 |
Providence Setting Facility Modifier None Typical Low $23.99 Median $32.36 Typical High $38.90 | Facility | None | $23.99 | $32.36 | $38.90 |
Providence Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $19.50 Median $25.12 Typical High $37.15 | Professional | None | $19.50 | $25.12 | $37.15 |
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 $9.33 Median $10.00 Typical High $10.96 | Professional | 52 · Reduced service | $9.33 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.98 Typical High $4.37 | Professional | 53 · Discontinued | $3.72 | $3.98 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.02 Typical High $3.31 | Professional | 55 · Aftercare only | $2.82 | $3.02 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.00 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.86 | $2.00 | $2.19 |
Where California sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 35th of 51
$23.99
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.