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 $10.00 Median $10.00 Typical High $18.20 | Facility | None | $10.00 | $10.00 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.27 Median $7.59 Typical High $36.31 | Facility | None | $4.27 | $7.59 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $85.11 | Professional | None | $10.23 | $10.23 | $85.11 |
Blue Shield Setting Facility Modifier None Typical Low $10.00 Median $11.48 Typical High $33.11 | Facility | None | $10.00 | $11.48 | $33.11 |
Blue Shield Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $31.62 | Professional | None | $10.00 | $11.75 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $10.23 Median $20.42 Typical High $30.90 | Facility | None | $10.23 | $20.42 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Providence Setting Facility Modifier None Typical Low $10.23 Median $19.50 Typical High $32.36 | Facility | None | $10.23 | $19.50 | $32.36 |
Providence Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $50.12 | Professional | None | $10.23 | $10.23 | $50.12 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $10.47 | Facility | None | $3.89 | $3.89 | $10.47 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $51.29 | Professional | None | $10.00 | $10.00 | $51.29 |
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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | 55 · Aftercare only | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Where California sits
The same service costs 9.1 times more in Alabama than in 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· 40th of 51
$10.23
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.