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 $40.74 Median $40.74 Typical High $74.13 | Facility | None | $40.74 | $40.74 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | None | $40.74 | $40.74 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $45.71 Median $52.48 Typical High $63.10 | Facility | None | $45.71 | $52.48 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $45.71 Typical High $97.72 | Professional | None | $21.88 | $45.71 | $97.72 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $74.13 Typical High $97.72 | Facility | None | $70.79 | $74.13 | $97.72 |
Blue Shield Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $131.83 | Professional | None | $87.10 | $87.10 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $51.29 Typical High $77.62 | Facility | None | $25.70 | $51.29 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $25.70 | Professional | None | $21.88 | $25.70 | $25.70 |
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 $27.54 Median $27.54 Typical High $33.11 | Professional | None | $27.54 | $27.54 | $33.11 |
Providence Setting Facility Modifier None Typical Low $25.70 Median $53.70 Typical High $77.62 | Facility | None | $25.70 | $53.70 | $77.62 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $40.74 | Professional | None | $21.88 | $25.70 | $40.74 |
United Setting Professional Modifier None Typical Low $28.84 Median $70.79 Typical High $134.90 | Professional | None | $28.84 | $70.79 | $134.90 |
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 $20.42 Typical High $20.89 | Professional | 52 · Reduced service | $19.95 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $8.13 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.17 Typical High $6.31 | Professional | 55 · Aftercare only | $6.03 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.17 |
Where California sits
The same service costs 3.1 times more in Wisconsin than in New York. 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
$47.86
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.