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 $13.18 Median $13.49 Typical High $23.99 | Facility | None | $13.18 | $13.49 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $14.13 Typical High $19.95 | Professional | None | $13.18 | $14.13 | $19.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $22.39 Typical High $46.77 | Facility | None | $14.45 | $22.39 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $13.18 Typical High $33.88 | Professional | None | $9.33 | $13.18 | $33.88 |
Blue Shield Setting Facility Modifier None Typical Low $12.88 Median $15.14 Typical High $30.20 | Facility | None | $12.88 | $15.14 | $30.20 |
Blue Shield Setting Professional Modifier None Typical Low $13.18 Median $16.22 Typical High $35.48 | Professional | None | $13.18 | $16.22 | $35.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.02 Median $14.45 Typical High $19.95 | Professional | None | $12.02 | $14.45 | $19.95 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $24.55 Typical High $33.11 | Facility | None | $13.80 | $24.55 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $35.48 | Professional | None | $12.02 | $15.85 | $35.48 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Providence Setting Facility Modifier None Typical Low $13.18 Median $20.42 Typical High $35.48 | Facility | None | $13.18 | $20.42 | $35.48 |
Providence Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $23.44 | Professional | None | $13.18 | $13.18 | $23.44 |
Sutter Health Plus Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
United Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $40.74 | Facility | None | $13.18 | $13.18 | $40.74 |
United Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $35.48 | Professional | None | $13.18 | $13.18 | $35.48 |
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 $6.61 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.61 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.32 | $1.35 | $1.35 |
Where California sits
The same service costs 1.5 times more in Alaska than in Delaware. 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· 13th of 51
$14.79
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.