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 $43.65 Median $43.65 Typical High $77.62 | Facility | None | $43.65 | $43.65 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | None | $43.65 | $43.65 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $72.44 Typical High $151.36 | Facility | None | $46.77 | $72.44 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $112.20 | Professional | None | $39.81 | $42.66 | $112.20 |
Blue Shield Setting Facility Modifier None Typical Low $41.69 Median $45.71 Typical High $95.50 | Facility | None | $41.69 | $45.71 | $95.50 |
Blue Shield Setting Professional Modifier None Typical Low $43.65 Median $53.70 Typical High $117.49 | Professional | None | $43.65 | $53.70 | $117.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $64.57 | Professional | None | $38.90 | $47.86 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $79.43 Typical High $109.65 | Facility | None | $43.65 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $117.49 | Professional | None | $38.90 | $51.29 | $117.49 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $77.62 Typical High $120.23 | Facility | None | $43.65 | $77.62 | $120.23 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | None | $43.65 | $43.65 | $53.70 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $112.20 | Professional | None | $42.66 | $42.66 | $112.20 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where California sits
The same service costs 1.6 times more in Arizona than in Maryland. 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· 15th of 51
$45.71
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.