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 $22.39 Median $22.91 Typical High $41.69 | Facility | None | $22.39 | $22.91 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $22.91 Typical High $22.91 | Professional | None | $22.39 | $22.91 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $26.92 Typical High $33.88 | Facility | None | $22.91 | $26.92 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $23.99 Typical High $48.98 | Professional | None | $22.91 | $23.99 | $48.98 |
Blue Shield Setting Facility Modifier None Typical Low $29.51 Median $36.31 Typical High $52.48 | Facility | None | $29.51 | $36.31 | $52.48 |
Blue Shield Setting Professional Modifier None Typical Low $22.39 Median $27.54 Typical High $67.61 | Professional | None | $22.39 | $27.54 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $41.69 Typical High $56.23 | Facility | None | $23.44 | $41.69 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Contra Costa Health Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $60.26 | Professional | None | $20.42 | $27.54 | $60.26 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $38.90 Typical High $60.26 | Facility | None | $22.39 | $38.90 | $60.26 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $36.31 | Professional | None | $22.39 | $22.39 | $36.31 |
Sutter Health Plus Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $83.18 | Professional | None | $22.91 | $22.91 | $83.18 |
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 $11.22 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $11.22 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $4.47 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.24 | $2.29 | $2.29 |
Where California sits
The same service costs 1.9 times more in Alaska than in Mississippi. 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· 15th of 51
$25.70
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.