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 $8.51 Median $8.71 Typical High $17.38 | Facility | None | $8.51 | $8.71 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | None | $8.51 | $8.51 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $10.72 Typical High $12.59 | Facility | None | $9.33 | $10.72 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $27.54 | Professional | None | $9.33 | $9.33 | $27.54 |
Blue Shield Setting Facility Modifier None Typical Low $12.02 Median $38.02 Typical High $48.98 | Facility | None | $12.02 | $38.02 | $48.98 |
Blue Shield Setting Professional Modifier None Typical Low $8.51 Median $10.47 Typical High $33.88 | Professional | None | $8.51 | $10.47 | $33.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.59 Median $9.33 Typical High $12.88 | Professional | None | $7.59 | $9.33 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $15.49 Typical High $21.38 | Facility | None | $8.91 | $15.49 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.59 Median $11.22 Typical High $23.99 | Professional | None | $7.59 | $11.22 | $23.99 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Providence Setting Facility Modifier None Typical Low $8.71 Median $16.22 Typical High $25.70 | Facility | None | $8.71 | $16.22 | $25.70 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $18.62 | Professional | None | $8.51 | $8.51 | $18.62 |
Sutter Health Plus Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $36.31 | Professional | None | $9.33 | $9.33 | $36.31 |
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 $4.27 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.70 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Where California sits
The same service costs 6.5 times more in Oklahoma than in Alabama. 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· 23rd of 51
$9.77
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.