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 $1.12 Median $1.12 Typical High $2.29 | Facility | None | $1.12 | $1.12 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.12 Median $1.26 Typical High $1.70 | Professional | None | $1.12 | $1.26 | $1.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.23 Median $1.86 Typical High $3.89 | Facility | None | $1.23 | $1.86 | $3.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.12 Typical High $3.39 | Professional | None | $1.10 | $1.12 | $3.39 |
Blue Shield Setting Facility Modifier None Typical Low $1.48 Median $2.29 Typical High $3.24 | Facility | None | $1.48 | $2.29 | $3.24 |
Blue Shield Setting Professional Modifier None Typical Low $1.12 Median $1.38 Typical High $3.16 | Professional | None | $1.12 | $1.38 | $3.16 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.02 Median $1.26 Typical High $1.70 | Professional | None | $1.02 | $1.26 | $1.70 |
Cigna Setting Facility Modifier None Typical Low $1.17 Median $2.09 Typical High $2.82 | Facility | None | $1.17 | $2.09 | $2.82 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | None | $1.23 | $1.23 | $1.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.02 Median $1.32 Typical High $3.02 | Professional | None | $1.02 | $1.32 | $3.02 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Providence Setting Facility Modifier None Typical Low $1.12 Median $2.04 Typical High $3.16 | Facility | None | $1.12 | $2.04 | $3.16 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $2.14 | Professional | None | $1.12 | $1.12 | $2.14 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
United Setting Facility Modifier None Typical Low $1.12 Median $1.12 Typical High $3.72 | Facility | None | $1.12 | $1.12 | $3.72 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $3.72 | Professional | None | $1.10 | $1.10 | $3.72 |
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 $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 53 · Discontinued | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where California sits
The same service costs 2.2 times more in Wyoming than in Rhode Island. 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
$1.35
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.