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 $28.18 Median $28.18 Typical High $37.15 | Facility | None | $28.18 | $28.18 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.99 Median $30.20 Typical High $41.69 | Facility | None | $23.99 | $30.20 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $25.12 Typical High $81.28 | Professional | None | $24.55 | $25.12 | $81.28 |
Blue Shield Setting Facility Modifier None Typical Low $35.48 Median $36.31 Typical High $50.12 | Facility | None | $35.48 | $36.31 | $50.12 |
Blue Shield Setting Professional Modifier None Typical Low $28.18 Median $34.67 Typical High $69.18 | Professional | None | $28.18 | $34.67 | $69.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $42.66 | Professional | None | $25.12 | $30.90 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $29.51 Median $51.29 Typical High $70.79 | Facility | None | $29.51 | $51.29 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Contra Costa Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $24.55 Median $29.51 Typical High $75.86 | Professional | None | $24.55 | $29.51 | $75.86 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $43.65 Typical High $75.86 | Facility | None | $28.18 | $43.65 | $75.86 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $40.74 | Professional | None | $28.18 | $28.18 | $40.74 |
Sutter Health Plus Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
United Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $95.50 | Professional | None | $24.55 | $24.55 | $95.50 |
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 $14.13 Median $14.13 Typical High $14.13 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where California sits
The same service costs 2.2 times more in Alaska 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· 11th of 51
$30.20
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.