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 $72.44 Median $74.13 Typical High $79.43 | Facility | None | $72.44 | $74.13 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $79.43 | Professional | None | $67.61 | $72.44 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $100.00 Typical High $407.38 | Professional | None | $39.81 | $100.00 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Contra Costa Health Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | None | $72.44 | $72.44 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $407.38 Typical High $831.76 | Professional | None | $72.44 | $407.38 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | None | $537.03 | $724.44 | $724.44 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $117.49 Typical High $141.25 | Facility | None | $87.10 | $117.49 | $141.25 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $138.04 | Professional | None | $69.18 | $89.13 | $138.04 |
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 $33.88 Median $36.31 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $13.49 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.72 Typical High $11.75 | Professional | 55 · Aftercare only | $10.00 | $10.72 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $7.24 | $7.94 |
Where California sits
The same service costs 3.6 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· 36th of 51
$87.10
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.