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 $53.70 Median $54.95 Typical High $93.33 | Facility | None | $53.70 | $54.95 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $54.95 Typical High $81.28 | Professional | None | $53.70 | $54.95 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $60.26 Typical High $79.43 | Facility | None | $51.29 | $60.26 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $51.29 Typical High $109.65 | Professional | None | $4.57 | $51.29 | $109.65 |
Blue Shield Setting Facility Modifier None Typical Low $50.12 Median $52.48 Typical High $75.86 | Facility | None | $50.12 | $52.48 | $75.86 |
Blue Shield Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $114.82 | Professional | None | $53.70 | $63.10 | $114.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $81.28 | Professional | None | $48.98 | $58.88 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $97.72 Typical High $134.90 | Facility | None | $56.23 | $97.72 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Contra Costa Health Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $144.54 | Professional | None | $48.98 | $61.66 | $144.54 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $81.28 Typical High $144.54 | Facility | None | $51.29 | $81.28 | $144.54 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $56.23 | Professional | None | $53.70 | $53.70 | $56.23 |
Sutter Health Plus Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $138.04 | Professional | None | $51.29 | $51.29 | $138.04 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.72 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.37 | $5.50 | $5.50 |
Where California sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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· 32nd of 51
$53.70
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.