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 $3.47 Median $3.47 Typical High $5.89 | Facility | None | $3.47 | $3.47 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.72 Median $5.75 Typical High $11.48 | Facility | None | $3.72 | $5.75 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $8.51 | Professional | None | $3.24 | $3.39 | $8.51 |
Blue Shield Setting Facility Modifier None Typical Low $3.72 Median $4.17 Typical High $7.59 | Facility | None | $3.72 | $4.17 | $7.59 |
Blue Shield Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $9.12 | Professional | None | $3.47 | $4.17 | $9.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.09 Median $3.80 Typical High $5.25 | Professional | None | $3.09 | $3.80 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $6.31 Typical High $8.71 | Facility | None | $3.63 | $6.31 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $3.89 Typical High $9.33 | Professional | None | $3.09 | $3.89 | $9.33 |
Providence Setting Facility Modifier None Typical Low $3.47 Median $6.17 Typical High $9.55 | Facility | None | $3.47 | $6.17 | $9.55 |
Providence Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.89 | Professional | None | $3.47 | $3.47 | $3.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $9.33 | Facility | None | $3.47 | $3.47 | $9.33 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $9.33 | Professional | None | $3.24 | $3.24 | $9.33 |
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 $1.74 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.69 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Where California sits
The same service costs 2.1 times more in Alaska than in Oklahoma. 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· 11th of 51
$3.89
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.