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 $1.95 Median $1.95 Typical High $4.07 | Facility | None | $1.95 | $1.95 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $1.91 Median $2.09 Typical High $3.02 | Professional | None | $1.91 | $2.09 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.91 Median $2.24 Typical High $2.88 | Facility | None | $1.91 | $2.24 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $2.00 Typical High $4.79 | Professional | None | $1.95 | $2.00 | $4.79 |
Blue Shield Setting Facility Modifier None Typical Low $2.69 Median $3.24 Typical High $4.47 | Facility | None | $2.69 | $3.24 | $4.47 |
Blue Shield Setting Professional Modifier None Typical Low $2.09 Median $2.51 Typical High $6.17 | Professional | None | $2.09 | $2.51 | $6.17 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.74 Median $2.14 Typical High $2.88 | Professional | None | $1.74 | $2.14 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $2.00 Median $3.55 Typical High $4.79 | Facility | None | $2.00 | $3.55 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.74 Median $2.29 Typical High $5.37 | Professional | None | $1.74 | $2.29 | $5.37 |
Molina Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Providence Setting Facility Modifier None Typical Low $1.91 Median $3.09 Typical High $5.13 | Facility | None | $1.91 | $3.09 | $5.13 |
Providence Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.75 | Professional | None | $1.91 | $1.91 | $2.75 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
United Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $4.79 | Professional | None | $1.95 | $1.95 | $4.79 |
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 $0.98 Median $0.98 Typical High $0.98 | Professional | 52 · Reduced service | $0.98 | $0.98 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 53 · Discontinued | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Where California sits
The same service costs 2.5 times more in Texas than in Tennessee. 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· 22nd of 51
$2.14
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.