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 $67.61 Median $67.61 Typical High $123.03 | Facility | None | $67.61 | $67.61 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $100.00 | Professional | None | $67.61 | $72.44 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $114.82 Typical High $229.09 | Facility | None | $72.44 | $114.82 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $144.54 | Professional | None | $67.61 | $67.61 | $144.54 |
Blue Shield Setting Facility Modifier None Typical Low $72.44 Median $81.28 Typical High $138.04 | Facility | None | $72.44 | $81.28 | $138.04 |
Blue Shield Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $213.80 | Professional | None | $67.61 | $79.43 | $213.80 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $100.00 | Professional | None | $60.26 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $123.03 Typical High $165.96 | Facility | None | $69.18 | $123.03 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $186.21 | Professional | None | $60.26 | $81.28 | $186.21 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $120.23 Typical High $186.21 | Facility | None | $67.61 | $120.23 | $186.21 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | None | $67.61 | $67.61 | $77.62 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $316.23 | Facility | None | $67.61 | $67.61 | $316.23 |
United Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $263.03 | Professional | None | $67.61 | $67.61 | $263.03 |
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 $33.11 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where California sits
The same service costs 2.0 times more in Oklahoma 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· 13th of 51
$77.62
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.