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 $0.55 Median $0.55 Typical High $0.89 | Facility | None | $0.55 | $0.55 | $0.89 |
Aetna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.43 Median $0.60 Typical High $0.81 | Facility | None | $0.43 | $0.60 | $0.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.42 Median $0.44 Typical High $1.70 | Professional | None | $0.42 | $0.44 | $1.70 |
Blue Shield Setting Facility Modifier None Typical Low $0.71 Median $0.87 Typical High $1.23 | Facility | None | $0.71 | $0.87 | $1.23 |
Blue Shield Setting Professional Modifier None Typical Low $0.55 Median $0.68 Typical High $1.41 | Professional | None | $0.55 | $0.68 | $1.41 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.49 Median $0.60 Typical High $0.81 | Professional | None | $0.49 | $0.60 | $0.81 |
Cigna Setting Facility Modifier None Typical Low $0.56 Median $1.00 Typical High $1.38 | Facility | None | $0.56 | $1.00 | $1.38 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.42 Median $0.55 Typical High $1.51 | Professional | None | $0.42 | $0.55 | $1.51 |
Molina Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | None | $0.47 | $0.47 | $0.47 |
Providence Setting Facility Modifier None Typical Low $0.55 Median $1.02 Typical High $1.51 | Facility | None | $0.55 | $1.02 | $1.51 |
Providence Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.87 | Professional | None | $0.55 | $0.55 | $0.87 |
Sutter Health Plus Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | None | $0.87 | $0.87 | $0.87 |
United Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
United Setting Professional Modifier None Typical Low $0.42 Median $0.42 Typical High $2.57 | Professional | None | $0.42 | $0.42 | $2.57 |
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 $0.28 Median $0.28 Typical High $0.28 | Professional | 52 · Reduced service | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where California sits
The same service costs 2.1 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· 18th of 51
$0.56
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.