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 $39.81 Median $39.81 Typical High $72.44 | Facility | None | $39.81 | $39.81 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $42.66 Typical High $47.86 | Facility | None | $0.03 | $42.66 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $40.74 Typical High $128.82 | Professional | None | $11.22 | $40.74 | $128.82 |
Blue Shield Setting Facility Modifier None Typical Low $40.74 Median $42.66 Typical High $83.18 | Facility | None | $40.74 | $42.66 | $83.18 |
Blue Shield Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $114.82 | Professional | None | $43.65 | $50.12 | $114.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $60.26 | Professional | None | $39.81 | $52.48 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $85.11 Typical High $128.82 | Facility | None | $42.66 | $85.11 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $57.54 Typical High $112.20 | Facility | None | $33.11 | $57.54 | $112.20 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $42.66 Typical High $42.66 | Professional | None | $22.91 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $114.82 | Professional | None | $50.12 | $50.12 | $114.82 |
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 $19.95 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Where California sits
The same service costs 15.1 times more in Alabama than in Montana. 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· 26th of 51
$42.66
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.