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 $12.02 Median $12.30 Typical High $13.18 | Facility | None | $12.02 | $12.30 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $13.18 | Professional | None | $11.22 | $12.02 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $16.98 Typical High $69.18 | Professional | None | $6.76 | $16.98 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | None | $12.02 | $12.02 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $407.38 Typical High $831.76 | Professional | None | $12.02 | $407.38 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $123.03 | Professional | None | $91.20 | $123.03 | $123.03 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $19.95 Typical High $23.99 | Facility | None | $14.45 | $19.95 | $23.99 |
Providence Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $11.22 Median $14.79 Typical High $25.12 | Professional | None | $11.22 | $14.79 | $25.12 |
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 $5.50 Median $6.03 Typical High $6.61 | Professional | 52 · Reduced service | $5.50 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.40 Typical High $2.63 | Professional | 53 · Discontinued | $2.24 | $2.40 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.82 Typical High $2.00 | Professional | 55 · Aftercare only | $1.66 | $1.82 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.20 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.12 | $1.20 | $1.32 |
Where California sits
The same service costs 4.9 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· 34th of 51
$14.45
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.