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 $0.85 Median $0.87 Typical High $1.82 | Facility | None | $0.85 | $0.87 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $0.85 Median $0.87 Typical High $0.87 | Professional | None | $0.85 | $0.87 | $0.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.07 Median $1.66 Typical High $3.47 | Facility | None | $1.07 | $1.66 | $3.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $4.90 | Professional | None | $1.00 | $1.00 | $4.90 |
Blue Shield Setting Facility Modifier None Typical Low $1.15 Median $2.45 Typical High $3.47 | Facility | None | $1.15 | $2.45 | $3.47 |
Blue Shield Setting Professional Modifier None Typical Low $0.85 Median $1.00 Typical High $2.45 | Professional | None | $0.85 | $1.00 | $2.45 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.78 Median $0.95 Typical High $1.29 | Professional | None | $0.78 | $0.95 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.58 Typical High $2.14 | Facility | None | $0.89 | $1.58 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | None | $0.85 | $0.85 | $0.85 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | None | $0.87 | $0.87 | $0.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.78 Median $1.17 Typical High $2.29 | Professional | None | $0.78 | $1.17 | $2.29 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Providence Setting Facility Modifier None Typical Low $0.85 Median $1.55 Typical High $2.40 | Facility | None | $0.85 | $1.55 | $2.40 |
Providence Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $1.86 | Professional | None | $0.85 | $0.85 | $1.86 |
United Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $4.79 | Facility | None | $0.85 | $0.85 | $4.79 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $2.75 | Professional | None | $1.00 | $1.00 | $2.75 |
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 $0.43 Median $0.44 Typical High $0.44 | Professional | 52 · Reduced service | $0.43 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 53 · Discontinued | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where California sits
The same service costs 4.1 times more in Oklahoma than in North Dakota. 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· 8th of 51
$1.12
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.