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 $77.62 Median $79.43 Typical High $85.11 | Facility | None | $77.62 | $79.43 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | None | $77.62 | $79.43 | $79.43 |
Anthem BCBS Setting Facility Modifier None Typical Low $47.86 Median $85.11 Typical High $114.82 | Facility | None | $47.86 | $85.11 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $46.77 Typical High $489.78 | Professional | None | $10.00 | $46.77 | $489.78 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $83.18 Typical High $162.18 | Facility | None | $74.13 | $83.18 | $162.18 |
Blue Shield Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $169.82 | Professional | None | $85.11 | $97.72 | $169.82 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $117.49 | Professional | None | $69.18 | $85.11 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $141.25 Typical High $194.98 | Facility | None | $81.28 | $141.25 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $208.93 | Professional | None | $46.77 | $69.18 | $208.93 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $144.54 Typical High $234.42 | Facility | None | $77.62 | $144.54 | $234.42 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $169.82 | Professional | None | $77.62 | $77.62 | $169.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $158.49 | Professional | None | $46.77 | $46.77 | $158.49 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.49 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $7.94 |
Where California sits
The same service costs 3.6 times more in Texas than in Kansas. 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
$79.43
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.