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 $1.15 Median $1.15 Typical High $2.09 | Facility | None | $1.15 | $1.15 | $2.09 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.20 Typical High $1.32 | Professional | None | $1.12 | $1.20 | $1.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.15 Median $1.35 Typical High $1.70 | Facility | None | $1.15 | $1.35 | $1.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $7.94 | Professional | None | $1.17 | $1.17 | $7.94 |
Blue Shield Setting Facility Modifier None Typical Low $1.17 Median $1.32 Typical High $2.51 | Facility | None | $1.17 | $1.32 | $2.51 |
Blue Shield Setting Professional Modifier None Typical Low $1.15 Median $1.35 Typical High $3.02 | Professional | None | $1.15 | $1.35 | $3.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.15 Median $1.51 Typical High $1.74 | Professional | None | $1.15 | $1.51 | $1.74 |
Cigna Setting Facility Modifier None Typical Low $1.17 Median $2.34 Typical High $3.55 | Facility | None | $1.17 | $2.34 | $3.55 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $3.02 Typical High $3.98 | Professional | None | $2.00 | $3.02 | $3.98 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Providence Setting Facility Modifier None Typical Low $1.17 Median $1.66 Typical High $3.16 | Facility | None | $1.17 | $1.66 | $3.16 |
Providence Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
United Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $5.13 | Professional | None | $1.15 | $1.15 | $5.13 |
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 $0.58 Median $0.58 Typical High $0.58 | Professional | 52 · Reduced service | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where California sits
The same service costs 1.7 times more in Alaska 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· 15th of 51
$1.17
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.