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 $4.37 Median $4.37 Typical High $7.76 | Facility | None | $4.37 | $4.37 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.09 Median $4.68 Typical High $8.71 | Facility | None | $3.09 | $4.68 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $4.47 Typical High $8.71 | Professional | None | $3.47 | $4.47 | $8.71 |
Blue Shield Setting Facility Modifier None Typical Low $4.37 Median $5.13 Typical High $7.76 | Facility | None | $4.37 | $5.13 | $7.76 |
Blue Shield Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $10.72 | Professional | None | $4.37 | $5.13 | $10.72 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.37 Median $5.62 Typical High $6.46 | Professional | None | $4.37 | $5.62 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $8.91 Typical High $13.49 | Facility | None | $4.47 | $8.91 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $7.08 Typical High $10.00 | Professional | None | $5.01 | $7.08 | $10.00 |
Providence Setting Facility Modifier None Typical Low $4.47 Median $6.17 Typical High $12.02 | Facility | None | $4.47 | $6.17 | $12.02 |
Providence Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $7.94 | Facility | None | $2.45 | $2.45 | $7.94 |
United Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $11.75 | Professional | None | $4.37 | $4.37 | $11.75 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.43 |
Where California sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 22nd of 51
$4.47
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.