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 $1.38 Median $1.38 Typical High $2.34 | Facility | None | $1.38 | $1.38 | $2.34 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.51 Median $2.29 Typical High $4.57 | Facility | None | $1.51 | $2.29 | $4.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.29 Typical High $3.16 | Professional | None | $1.05 | $1.29 | $3.16 |
Blue Shield Setting Facility Modifier None Typical Low $1.23 Median $1.51 Typical High $2.75 | Facility | None | $1.23 | $1.51 | $2.75 |
Blue Shield Setting Professional Modifier None Typical Low $1.38 Median $1.66 Typical High $3.47 | Professional | None | $1.38 | $1.66 | $3.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.23 Median $1.51 Typical High $2.04 | Professional | None | $1.23 | $1.51 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $2.51 Typical High $3.55 | Facility | None | $1.45 | $2.51 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.23 Median $1.55 Typical High $3.72 | Professional | None | $1.23 | $1.55 | $3.72 |
Providence Setting Facility Modifier None Typical Low $1.38 Median $2.51 Typical High $3.80 | Facility | None | $1.38 | $2.51 | $3.80 |
Providence Setting Professional Modifier None Typical Low $1.38 Median $1.41 Typical High $1.51 | Professional | None | $1.38 | $1.41 | $1.51 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
United Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $3.47 | Facility | None | $1.38 | $1.38 | $3.47 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $3.55 | Professional | None | $1.29 | $1.29 | $3.55 |
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 $0.69 Median $0.71 Typical High $0.71 | Professional | 52 · Reduced service | $0.69 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where California sits
The same service costs 1.7 times more in Arizona than in Iowa. 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· 12th of 51
$1.48
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.