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 $1.07 Median $1.07 Typical High $1.95 | Facility | None | $1.07 | $1.07 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.17 | Professional | None | $1.07 | $1.07 | $1.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.31 Median $0.35 Typical High $0.42 | Facility | None | $0.31 | $0.35 | $0.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $9.55 | Professional | None | $0.31 | $0.31 | $9.55 |
Blue Shield Setting Facility Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Facility | None | $1.66 | $1.66 | $1.66 |
Blue Shield Setting Professional Modifier None Typical Low $0.66 Median $0.78 Typical High $1.74 | Professional | None | $0.66 | $0.78 | $1.74 |
Cigna Setting Facility Modifier None Typical Low $0.65 Median $1.29 Typical High $1.95 | Facility | None | $0.65 | $1.29 | $1.95 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Molina Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Providence Setting Facility Modifier None Typical Low $0.65 Median $1.35 Typical High $1.95 | Facility | None | $0.65 | $1.35 | $1.95 |
Providence Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | None | $0.65 | $0.65 | $0.68 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $1.00 | Professional | None | $0.36 | $0.36 | $1.00 |
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 $0.54 Median $0.54 Typical High $0.54 | Professional | 52 · Reduced service | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 55 · Aftercare only | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where California sits
The same service costs 27.5 times more in Kansas than in New York. 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· 37th of 51
$0.65
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.