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 $14.13 Median $14.13 Typical High $25.12 | Facility | None | $14.13 | $14.13 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $23.44 Typical High $47.86 | Facility | None | $15.14 | $23.44 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $14.45 Typical High $38.90 | Professional | None | $13.80 | $14.45 | $38.90 |
Blue Shield Setting Facility Modifier None Typical Low $18.62 Median $20.42 Typical High $35.48 | Facility | None | $18.62 | $20.42 | $35.48 |
Blue Shield Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $38.02 | Professional | None | $14.13 | $16.60 | $38.02 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.59 Median $15.49 Typical High $20.89 | Professional | None | $12.59 | $15.49 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $25.70 Typical High $35.48 | Facility | None | $14.45 | $25.70 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.59 Median $16.60 Typical High $37.15 | Professional | None | $12.59 | $16.60 | $37.15 |
Providence Setting Facility Modifier None Typical Low $14.13 Median $25.12 Typical High $38.90 | Facility | None | $14.13 | $25.12 | $38.90 |
Providence Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $21.88 | Professional | None | $14.13 | $14.13 | $21.88 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $48.98 | Professional | None | $13.80 | $13.80 | $48.98 |
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 $7.08 Median $7.08 Typical High $7.08 | Professional | 52 · Reduced service | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 53 · Discontinued | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $2.09 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.41 | $1.41 | $1.41 |
Where California sits
The same service costs 1.8 times more in Alaska 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· 5th of 51
$18.20
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.