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 $20.42 Median $20.42 Typical High $58.88 | Facility | None | $20.42 | $20.42 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $39.81 | Professional | None | $20.42 | $20.42 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $41.69 Typical High $100.00 | Facility | None | $27.54 | $41.69 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $131.83 | Professional | None | $32.36 | $33.11 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $28.84 Median $75.86 Typical High $97.72 | Facility | None | $28.84 | $75.86 | $97.72 |
Blue Shield Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $69.18 | Professional | None | $20.42 | $24.55 | $69.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $30.20 | Professional | None | $18.20 | $22.39 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $37.15 Typical High $51.29 | Facility | None | $20.42 | $37.15 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $18.20 Median $33.11 Typical High $72.44 | Professional | None | $18.20 | $33.11 | $72.44 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $38.02 Typical High $57.54 | Facility | None | $20.42 | $38.02 | $57.54 |
Providence Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $25.12 | Professional | None | $20.42 | $20.42 | $25.12 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $89.13 | Professional | None | $32.36 | $32.36 | $89.13 |
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 $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $3.02 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where California sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 10th of 51
$33.11
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.