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 $3.55 Median $3.55 Typical High $7.24 | Facility | None | $3.55 | $3.55 | $7.24 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.80 Median $5.89 Typical High $12.02 | Facility | None | $3.80 | $5.89 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $9.55 | Professional | None | $3.55 | $3.55 | $9.55 |
Blue Shield Setting Facility Modifier None Typical Low $3.55 Median $4.17 Typical High $8.51 | Facility | None | $3.55 | $4.17 | $8.51 |
Blue Shield Setting Professional Modifier None Typical Low $3.55 Median $4.27 Typical High $9.77 | Professional | None | $3.55 | $4.27 | $9.77 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.16 Median $3.89 Typical High $5.25 | Professional | None | $3.16 | $3.89 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $6.46 Typical High $8.71 | Facility | None | $3.63 | $6.46 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.16 Median $4.17 Typical High $9.77 | Professional | None | $3.16 | $4.17 | $9.77 |
Providence Setting Facility Modifier None Typical Low $3.55 Median $6.31 Typical High $9.77 | Facility | None | $3.55 | $6.31 | $9.77 |
Providence Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Professional | None | $3.55 | $3.55 | $3.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $10.72 | Facility | None | $3.55 | $3.55 | $10.72 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $9.33 | Professional | None | $3.55 | $3.55 | $9.33 |
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 $1.78 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.35 | $0.36 | $0.36 |
Where California sits
The same service costs 1.7 times more in Arizona than in Illinois. 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
$3.89
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.