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 $1.29 Median $1.32 Typical High $2.63 | Facility | None | $1.29 | $1.32 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.32 Typical High $1.95 | Professional | None | $1.29 | $1.32 | $1.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.26 Median $1.48 Typical High $1.95 | Facility | None | $1.26 | $1.48 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.29 Typical High $8.71 | Professional | None | $1.26 | $1.29 | $8.71 |
Blue Shield Setting Facility Modifier None Typical Low $1.70 Median $2.34 Typical High $3.16 | Facility | None | $1.70 | $2.34 | $3.16 |
Blue Shield Setting Professional Modifier None Typical Low $1.29 Median $1.58 Typical High $4.07 | Professional | None | $1.29 | $1.58 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $2.34 Typical High $3.24 | Facility | None | $1.35 | $2.34 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.17 Median $1.51 Typical High $3.63 | Professional | None | $1.17 | $1.51 | $3.63 |
Molina Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Providence Setting Facility Modifier None Typical Low $1.29 Median $2.45 Typical High $3.98 | Facility | None | $1.29 | $2.45 | $3.98 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $2.82 | Professional | None | $1.29 | $1.29 | $2.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $3.47 | Professional | None | $1.26 | $1.26 | $3.47 |
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 $0.65 Median $0.66 Typical High $0.66 | Professional | 52 · Reduced service | $0.65 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where California sits
The same service costs 2.5 times more in Texas than in Nebraska. 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· 12th of 51
$1.45
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.