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 $20.89 Median $21.38 Typical High $42.66 | Facility | None | $20.89 | $21.38 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $31.62 | Professional | None | $20.89 | $22.91 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $37.15 Typical High $74.13 | Facility | None | $23.44 | $37.15 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $22.91 Typical High $52.48 | Professional | None | $21.88 | $22.91 | $52.48 |
Blue Shield Setting Facility Modifier None Typical Low $27.54 Median $37.15 Typical High $61.66 | Facility | None | $27.54 | $37.15 | $61.66 |
Blue Shield Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $64.57 | Professional | None | $20.89 | $25.70 | $64.57 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.05 Median $23.44 Typical High $31.62 | Professional | None | $19.05 | $23.44 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $38.90 Typical High $52.48 | Facility | None | $21.88 | $38.90 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.05 Median $26.30 Typical High $56.23 | Professional | None | $19.05 | $26.30 | $56.23 |
Providence Setting Facility Modifier None Typical Low $20.89 Median $38.02 Typical High $58.88 | Facility | None | $20.89 | $38.02 | $58.88 |
Providence Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $38.90 | Professional | None | $20.89 | $20.89 | $38.90 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $91.20 | Professional | None | $21.88 | $21.88 | $91.20 |
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 $10.47 Median $10.72 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.14 |
Where California sits
The same service costs 2.6 times more in Wyoming than in Texas. 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· 8th of 51
$25.70
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.