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 $0.23 Median $0.23 Typical High $0.42 | Facility | None | $0.23 | $0.23 | $0.42 |
Aetna Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | None | $0.23 | $0.23 | $0.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.24 Median $0.28 Typical High $0.34 | Facility | None | $0.24 | $0.28 | $0.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.46 | Professional | None | $0.24 | $0.24 | $0.46 |
Blue Shield Setting Facility Modifier None Typical Low $0.24 Median $0.27 Typical High $0.50 | Facility | None | $0.24 | $0.27 | $0.50 |
Blue Shield Setting Professional Modifier None Typical Low $0.23 Median $0.27 Typical High $0.52 | Professional | None | $0.23 | $0.27 | $0.52 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.23 Median $0.30 Typical High $0.35 | Professional | None | $0.23 | $0.30 | $0.35 |
Cigna Setting Facility Modifier None Typical Low $0.24 Median $0.48 Typical High $0.72 | Facility | None | $0.24 | $0.48 | $0.72 |
Cigna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
Providence Setting Facility Modifier None Typical Low $0.24 Median $0.33 Typical High $0.65 | Facility | None | $0.24 | $0.33 | $0.65 |
Providence Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.63 | Professional | None | $0.23 | $0.23 | $0.63 |
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 $0.12 Median $0.12 Typical High $0.12 | Professional | 52 · Reduced service | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 53 · Discontinued | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where California sits
The same service costs 1.8 times more in Arizona than in Hawaii. 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· 16th of 51
$0.24
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.