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 $5.89 Median $5.89 Typical High $10.47 | Facility | None | $5.89 | $5.89 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.03 | Professional | None | $5.89 | $5.89 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $6.31 Typical High $7.08 | Facility | None | $0.03 | $6.31 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $16.98 | Professional | None | $6.03 | $6.03 | $16.98 |
Blue Shield Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Blue Shield Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $16.60 | Professional | None | $6.31 | $7.41 | $16.60 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $6.17 Median $7.94 Typical High $9.33 | Professional | None | $6.17 | $7.94 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $12.30 Typical High $18.62 | Facility | None | $6.17 | $12.30 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Providence Setting Facility Modifier None Typical Low $5.89 Median $8.32 Typical High $19.95 | Facility | None | $5.89 | $8.32 | $19.95 |
Providence Setting Professional Modifier None Typical Low $6.03 Median $6.17 Typical High $8.71 | Professional | None | $6.03 | $6.17 | $8.71 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.88 Typical High $28.18 | Professional | None | $12.30 | $12.88 | $28.18 |
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 $2.95 Median $2.95 Typical High $3.02 | Professional | 52 · Reduced service | $2.95 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.17 Median $1.17 Typical High $1.20 | Professional | 53 · Discontinued | $1.17 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.87 Median $0.87 Typical High $0.89 | Professional | 55 · Aftercare only | $0.87 | $0.87 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $0.60 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $0.60 |
Where California sits
The same service costs 2.1 times more in Iowa than in Montana. 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· 32nd of 51
$6.31
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.