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 $0.40 Median $0.40 Typical High $0.79 | Facility | None | $0.40 | $0.40 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.39 Median $0.45 Typical High $0.59 | Facility | None | $0.39 | $0.45 | $0.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.85 | Professional | None | $0.39 | $0.39 | $0.85 |
Blue Shield Setting Facility Modifier None Typical Low $0.48 Median $0.48 Typical High $0.68 | Facility | None | $0.48 | $0.48 | $0.68 |
Blue Shield Setting Professional Modifier None Typical Low $0.40 Median $0.48 Typical High $1.00 | Professional | None | $0.40 | $0.48 | $1.00 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.74 Typical High $1.00 | Facility | None | $0.42 | $0.74 | $1.00 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | None | $0.47 | $0.47 | $0.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.36 Median $0.47 Typical High $1.12 | Professional | None | $0.36 | $0.47 | $1.12 |
Molina Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Providence Setting Facility Modifier None Typical Low $0.40 Median $0.76 Typical High $1.10 | Facility | None | $0.40 | $0.76 | $1.10 |
Providence Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.55 | Professional | None | $0.40 | $0.40 | $0.55 |
United Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
United Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $1.23 | Professional | None | $0.39 | $0.39 | $1.23 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where California sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 27th of 51
$0.41
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.