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 $12.88 Median $12.88 Typical High $22.91 | Facility | None | $12.88 | $12.88 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $12.88 Typical High $12.88 | Professional | None | $10.72 | $12.88 | $12.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $13.80 Typical High $15.14 | Facility | None | $0.03 | $13.80 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $13.18 Typical High $25.12 | Professional | None | $5.75 | $13.18 | $25.12 |
Blue Shield Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Blue Shield Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $23.99 | Professional | None | $9.12 | $10.72 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $17.78 Typical High $26.92 | Facility | None | $8.91 | $17.78 | $26.92 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $15.85 Typical High $21.88 | Professional | None | $10.00 | $15.85 | $21.88 |
Molina Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Providence Setting Facility Modifier None Typical Low $8.91 Median $17.78 Typical High $26.92 | Facility | None | $8.91 | $17.78 | $26.92 |
Providence Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $21.88 | Professional | None | $8.91 | $8.91 | $21.88 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $41.69 | Professional | None | $15.49 | $15.49 | $41.69 |
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 $5.37 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $5.37 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.14 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.58 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.07 | $1.29 | $1.29 |
Where California sits
The same service costs 2.6 times more in Alaska than in Ohio. 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· 26th of 51
$13.18
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.