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 $5.62 Median $5.62 Typical High $10.23 | Facility | None | $5.62 | $5.62 | $10.23 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.03 Median $9.55 Typical High $19.95 | Facility | None | $6.03 | $9.55 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $5.62 Typical High $12.59 | Professional | None | $5.01 | $5.62 | $12.59 |
Blue Shield Setting Facility Modifier None Typical Low $6.61 Median $6.92 Typical High $12.30 | Facility | None | $6.61 | $6.92 | $12.30 |
Blue Shield Setting Professional Modifier None Typical Low $5.62 Median $6.76 Typical High $15.49 | Professional | None | $5.62 | $6.76 | $15.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $8.32 | Professional | None | $5.01 | $6.17 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $10.23 Typical High $13.80 | Facility | None | $5.75 | $10.23 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $6.76 Typical High $14.79 | Professional | None | $5.01 | $6.76 | $14.79 |
Molina Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Providence Setting Facility Modifier None Typical Low $5.62 Median $9.77 Typical High $14.79 | Facility | None | $5.62 | $9.77 | $14.79 |
Providence Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $8.13 | Professional | None | $5.62 | $5.62 | $8.13 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
United Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $16.60 | Facility | None | $5.62 | $5.62 | $16.60 |
United Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $16.22 | Professional | None | $5.62 | $5.62 | $16.22 |
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 $2.82 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.85 Typical High $0.85 | Professional | 55 · Aftercare only | $0.83 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Where California sits
The same service costs 1.7 times more in Arizona than in Vermont. 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· 7th of 51
$6.76
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.