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 $13.49 Median $13.49 Typical High $24.55 | Facility | None | $13.49 | $13.49 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $16.22 Typical High $20.42 | Facility | None | $13.80 | $16.22 | $20.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $28.18 | Professional | None | $13.80 | $13.80 | $28.18 |
Blue Shield Setting Facility Modifier None Typical Low $13.80 Median $15.49 Typical High $27.54 | Facility | None | $13.80 | $15.49 | $27.54 |
Blue Shield Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $36.31 | Professional | None | $13.49 | $15.85 | $36.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $13.49 Median $17.78 Typical High $20.42 | Professional | None | $13.49 | $17.78 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $27.54 Typical High $42.66 | Facility | None | $13.80 | $27.54 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $50.12 | Professional | None | $44.67 | $46.77 | $50.12 |
Providence Setting Facility Modifier None Typical Low $13.80 Median $19.50 Typical High $37.15 | Facility | None | $13.80 | $19.50 | $37.15 |
Providence Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $36.31 | Professional | None | $13.49 | $13.49 | $36.31 |
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 $6.76 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $2.04 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.35 |
Where California sits
The same service costs 9.1 times more in Alabama than in Hawaii. 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· 30th of 51
$13.80
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.