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 $54.95 Median $54.95 Typical High $100.00 | Facility | None | $54.95 | $54.95 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | None | $54.95 | $54.95 | $63.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $81.28 | Facility | None | $54.95 | $63.10 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $120.23 | Professional | None | $30.20 | $54.95 | $120.23 |
Blue Shield Setting Facility Modifier None Typical Low $66.07 Median $91.20 Typical High $107.15 | Facility | None | $66.07 | $91.20 | $107.15 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $72.44 Typical High $151.36 | Professional | None | $60.26 | $72.44 | $151.36 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $83.18 | Professional | None | $48.98 | $60.26 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $100.00 Typical High $138.04 | Facility | None | $57.54 | $100.00 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $154.88 | Professional | None | $48.98 | $66.07 | $154.88 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $85.11 Typical High $147.91 | Facility | None | $54.95 | $85.11 | $147.91 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $93.33 | Professional | None | $54.95 | $54.95 | $93.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $204.17 | Professional | None | $54.95 | $54.95 | $204.17 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $10.96 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $5.50 |
Where California sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 20th of 51
$60.26
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.