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 $43.65 Median $44.67 Typical High $97.72 | Facility | None | $43.65 | $44.67 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $44.67 | Professional | None | $43.65 | $44.67 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $64.57 | Facility | None | $47.86 | $58.88 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $223.87 | Professional | None | $54.95 | $56.23 | $223.87 |
Blue Shield Setting Facility Modifier None Typical Low $33.88 Median $39.81 Typical High $114.82 | Facility | None | $33.88 | $39.81 | $114.82 |
Blue Shield Setting Professional Modifier None Typical Low $43.65 Median $53.70 Typical High $141.25 | Professional | None | $43.65 | $53.70 | $141.25 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $66.07 | Professional | None | $39.81 | $47.86 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $109.65 | Facility | None | $45.71 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $123.03 | Professional | None | $39.81 | $60.26 | $123.03 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $83.18 Typical High $123.03 | Facility | None | $44.67 | $83.18 | $123.03 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $95.50 | Professional | None | $43.65 | $43.65 | $95.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $147.91 | Professional | None | $54.95 | $54.95 | $147.91 |
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 $21.88 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $21.88 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.71 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.37 | $4.47 | $4.47 |
Where California sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 18th of 51
$54.95
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.