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 $2.69 Median $2.69 Typical High $4.68 | Facility | None | $2.69 | $2.69 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $3.55 Typical High $7.76 | Facility | None | $2.69 | $3.55 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $2.57 Typical High $6.76 | Professional | None | $2.45 | $2.57 | $6.76 |
Blue Shield Setting Facility Modifier None Typical Low $2.57 Median $2.82 Typical High $5.75 | Facility | None | $2.57 | $2.82 | $5.75 |
Blue Shield Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $7.24 | Professional | None | $2.69 | $3.24 | $7.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.40 Median $2.95 Typical High $4.07 | Professional | None | $2.40 | $2.95 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $4.90 Typical High $6.76 | Facility | None | $2.82 | $4.90 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.40 Median $3.09 Typical High $7.24 | Professional | None | $2.40 | $3.09 | $7.24 |
Providence Setting Facility Modifier None Typical Low $2.69 Median $4.79 Typical High $7.59 | Facility | None | $2.69 | $4.79 | $7.59 |
Providence Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | None | $2.69 | $2.69 | $2.95 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $7.08 | Professional | None | $2.57 | $2.57 | $7.08 |
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 $1.35 Median $1.35 Typical High $1.35 | Professional | 52 · Reduced service | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 53 · Discontinued | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.41 Typical High $0.41 | Professional | 55 · Aftercare only | $0.40 | $0.41 | $0.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.27 |
Where California sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 34th of 51
$2.69
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.