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 $0.38 Median $0.38 Typical High $0.69 | Facility | None | $0.38 | $0.38 | $0.69 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | None | $0.38 | $0.38 | $0.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.39 Median $0.45 Typical High $0.56 | Facility | None | $0.39 | $0.45 | $0.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $2.04 | Professional | None | $0.39 | $0.39 | $2.04 |
Blue Shield Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $0.56 | Facility | None | $0.38 | $0.38 | $0.56 |
Blue Shield Setting Professional Modifier None Typical Low $0.38 Median $0.44 Typical High $0.98 | Professional | None | $0.38 | $0.44 | $0.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.08 Median $0.10 Typical High $0.12 | Professional | None | $0.08 | $0.10 | $0.12 |
Cigna Setting Facility Modifier None Typical Low $0.27 Median $0.54 Typical High $0.81 | Facility | None | $0.27 | $0.54 | $0.81 |
Cigna Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | None | $0.27 | $0.27 | $0.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $3.02 Typical High $3.98 | Professional | None | $2.00 | $3.02 | $3.98 |
Molina Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Providence Setting Facility Modifier None Typical Low $0.27 Median $0.54 Typical High $0.81 | Facility | None | $0.27 | $0.54 | $0.81 |
Providence Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | None | $0.27 | $0.27 | $0.27 |
United Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $2.51 | Professional | None | $0.38 | $0.38 | $2.51 |
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 $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
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 6.3 times more in Kansas than in Virginia. 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
$0.39
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.