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 $5.50 Median $5.50 Typical High $10.00 | Facility | None | $5.50 | $5.50 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $9.12 Typical High $19.05 | Facility | None | $5.89 | $9.12 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.50 Typical High $14.45 | Professional | None | $5.13 | $5.50 | $14.45 |
Blue Shield Setting Facility Modifier None Typical Low $5.37 Median $6.03 Typical High $12.30 | Facility | None | $5.37 | $6.03 | $12.30 |
Blue Shield Setting Professional Modifier None Typical Low $5.50 Median $6.61 Typical High $14.79 | Professional | None | $5.50 | $6.61 | $14.79 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.90 Median $6.03 Typical High $8.13 | Professional | None | $4.90 | $6.03 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $10.00 Typical High $13.80 | Facility | None | $5.50 | $10.00 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | None | $6.03 | $6.03 | $6.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $6.61 Typical High $14.45 | Professional | None | $4.90 | $6.61 | $14.45 |
Providence Setting Facility Modifier None Typical Low $5.50 Median $9.77 Typical High $15.14 | Facility | None | $5.50 | $9.77 | $15.14 |
Providence Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | None | $5.50 | $5.50 | $6.03 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.50 Median $5.75 Typical High $15.14 | Professional | None | $5.50 | $5.75 | $15.14 |
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 $2.75 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.81 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.55 |
Where California sits
The same service costs 1.9 times more in Alaska than in New Mexico. 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· 16th of 51
$6.03
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.