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 $61.66 Median $61.66 Typical High $112.20 | Facility | None | $61.66 | $61.66 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $66.07 Median $85.11 Typical High $194.98 | Facility | None | $66.07 | $85.11 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $173.78 | Professional | None | $33.88 | $63.10 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $208.93 | Facility | None | $63.10 | $75.86 | $208.93 |
Blue Shield Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $158.49 | Professional | None | $63.10 | $72.44 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $194.98 | Facility | None | $63.10 | $128.82 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $616.60 | Professional | None | $407.38 | $524.81 | $616.60 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $89.13 Typical High $173.78 | Facility | None | $61.66 | $89.13 | $173.78 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $245.47 | Professional | None | $63.10 | $63.10 | $245.47 |
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 $30.90 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Where California sits
The same service costs 3.2 times more in Kansas than in Arkansas. 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· 34th of 51
$63.10
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.