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 $0.68 Median $0.68 Typical High $1.23 | Facility | None | $0.68 | $0.68 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.72 Median $0.93 Typical High $2.34 | Facility | None | $0.72 | $0.93 | $2.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $2.09 | Professional | None | $0.71 | $0.71 | $2.09 |
Blue Shield Setting Facility Modifier None Typical Low $0.71 Median $0.78 Typical High $1.48 | Facility | None | $0.71 | $0.78 | $1.48 |
Blue Shield Setting Professional Modifier None Typical Low $0.74 Median $0.85 Typical High $1.95 | Professional | None | $0.74 | $0.85 | $1.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.68 Median $0.87 Typical High $1.02 | Professional | None | $0.68 | $0.87 | $1.02 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $1.41 Typical High $2.14 | Facility | None | $0.71 | $1.41 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.00 Median $2.00 Typical High $3.02 | Professional | None | $1.00 | $2.00 | $3.02 |
Providence Setting Facility Modifier None Typical Low $0.71 Median $0.98 Typical High $1.86 | Facility | None | $0.71 | $0.98 | $1.86 |
Providence Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.86 | Professional | None | $0.68 | $0.68 | $1.86 |
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 $0.34 Median $0.34 Typical High $0.34 | Professional | 52 · Reduced service | $0.34 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where California sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 9th of 51
$0.74
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.