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 $39.81 Median $39.81 Typical High $66.07 | Facility | None | $39.81 | $39.81 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | None | $39.81 | $39.81 | $45.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $67.61 Typical High $138.04 | Facility | None | $42.66 | $67.61 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $112.20 | Professional | None | $39.81 | $40.74 | $112.20 |
Blue Shield Setting Facility Modifier None Typical Low $38.90 Median $45.71 Typical High $100.00 | Facility | None | $38.90 | $45.71 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $112.20 | Professional | None | $39.81 | $47.86 | $112.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $60.26 | Professional | None | $39.81 | $51.29 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $77.62 Typical High $117.49 | Facility | None | $38.90 | $77.62 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $43.65 Typical High $87.10 | Professional | None | $38.02 | $43.65 | $87.10 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $57.54 Typical High $112.20 | Facility | None | $38.90 | $57.54 | $112.20 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $52.48 | Professional | None | $38.90 | $38.90 | $52.48 |
Sutter Health Plus Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $134.90 | Facility | None | $39.81 | $39.81 | $134.90 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $107.15 | Professional | None | $39.81 | $39.81 | $107.15 |
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 $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.13 Typical High $8.13 | Professional | 53 · Discontinued | $7.94 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $3.98 |
Where California sits
The same service costs 1.6 times more in Arizona 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· 15th of 51
$42.66
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.