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 $8.32 Median $8.51 Typical High $15.14 | Facility | None | $8.32 | $8.51 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.51 Typical High $8.51 | Professional | None | $8.32 | $8.51 | $8.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $10.96 Typical High $26.92 | Facility | None | $8.71 | $10.96 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $8.71 Typical High $72.44 | Professional | None | $8.32 | $8.71 | $72.44 |
Blue Shield Setting Facility Modifier None Typical Low $11.75 Median $66.07 Typical High $79.43 | Facility | None | $11.75 | $66.07 | $79.43 |
Blue Shield Setting Professional Modifier None Typical Low $8.32 Median $9.77 Typical High $20.89 | Professional | None | $8.32 | $9.77 | $20.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $12.59 | Professional | None | $7.59 | $9.12 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $8.71 Median $15.14 Typical High $20.89 | Facility | None | $8.71 | $15.14 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Contra Costa Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $22.39 | Professional | None | $7.59 | $10.00 | $22.39 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Providence Setting Facility Modifier None Typical Low $8.32 Median $15.85 Typical High $23.44 | Facility | None | $8.32 | $15.85 | $23.44 |
Providence Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $18.20 | Professional | None | $8.32 | $8.32 | $18.20 |
United Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $18.20 | Professional | None | $8.32 | $8.32 | $18.20 |
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 $4.17 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.17 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.66 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $0.83 |
Where California sits
The same service costs 7.4 times more in Wyoming than in New Jersey. 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· 18th of 51
$9.33
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.