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 $0.37 Median $0.37 Typical High $0.68 | Facility | None | $0.37 | $0.37 | $0.68 |
Aetna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | None | $0.37 | $0.37 | $0.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $3.80 Typical High $4.27 | Facility | None | $0.03 | $3.80 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $7.59 | Professional | None | $3.63 | $3.63 | $7.59 |
Blue Shield Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Blue Shield Setting Professional Modifier None Typical Low $3.24 Median $3.80 Typical High $8.51 | Professional | None | $3.24 | $3.80 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Providence Setting Facility Modifier None Typical Low $0.37 Median $0.52 Typical High $6.61 | Facility | None | $0.37 | $0.52 | $6.61 |
Providence Setting Professional Modifier None Typical Low $0.89 Median $3.55 Typical High $7.76 | Professional | None | $0.89 | $3.55 | $7.76 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $10.96 | Professional | None | $4.27 | $4.27 | $10.96 |
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 $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where California sits
The same service costs 14.1 times more in Wisconsin 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· 25th of 51
$3.63
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.