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 $24.55 Median $25.12 Typical High $43.65 | Facility | None | $24.55 | $25.12 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $37.15 | Professional | None | $24.55 | $26.92 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.92 Median $40.74 Typical High $85.11 | Facility | None | $26.92 | $40.74 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $63.10 | Professional | None | $21.38 | $23.99 | $63.10 |
Blue Shield Setting Facility Modifier None Typical Low $23.44 Median $25.70 Typical High $53.70 | Facility | None | $23.44 | $25.70 | $53.70 |
Blue Shield Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $66.07 | Professional | None | $25.12 | $30.20 | $66.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $22.39 Median $26.92 Typical High $37.15 | Professional | None | $22.39 | $26.92 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $44.67 Typical High $61.66 | Facility | None | $25.70 | $44.67 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $66.07 | Professional | None | $22.39 | $28.84 | $66.07 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $44.67 Typical High $69.18 | Facility | None | $24.55 | $44.67 | $69.18 |
Providence Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $30.20 | Professional | None | $24.55 | $24.55 | $30.20 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $46.77 | Facility | None | $24.55 | $24.55 | $46.77 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $50.12 | Professional | None | $23.99 | $23.99 | $50.12 |
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 $12.30 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.30 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | 53 · Discontinued | $4.90 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
Where California sits
The same service costs 1.6 times more in Alaska than in Mississippi. 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
$26.92
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.