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 $48.98 Median $48.98 Typical High $87.10 | Facility | None | $48.98 | $48.98 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $66.07 Typical High $144.54 | Facility | None | $51.29 | $66.07 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $50.12 Typical High $104.71 | Professional | None | $5.75 | $50.12 | $104.71 |
Blue Shield Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $72.44 | Facility | None | $50.12 | $52.48 | $72.44 |
Blue Shield Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $125.89 | Professional | None | $50.12 | $58.88 | $125.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $63.10 Typical High $72.44 | Professional | None | $48.98 | $63.10 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $151.36 | Facility | None | $50.12 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $112.20 | Professional | None | $48.98 | $89.13 | $112.20 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $69.18 Typical High $134.90 | Facility | None | $28.84 | $69.18 | $134.90 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $131.83 | Professional | None | $48.98 | $48.98 | $131.83 |
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 $23.99 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 53 · Discontinued | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Where California sits
The same service costs 1.7 times more in Alaska than in Montana. 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· 17th of 51
$50.12
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.