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 $4.27 Median $4.27 Typical High $8.51 | Facility | None | $4.27 | $4.27 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | None | $4.27 | $4.27 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.57 Median $5.37 Typical High $6.31 | Facility | None | $4.57 | $5.37 | $6.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.68 Median $4.90 Typical High $23.44 | Professional | None | $4.68 | $4.90 | $23.44 |
Blue Shield Setting Facility Modifier None Typical Low $6.03 Median $9.77 Typical High $13.80 | Facility | None | $6.03 | $9.77 | $13.80 |
Blue Shield Setting Professional Modifier None Typical Low $4.27 Median $5.13 Typical High $16.98 | Professional | None | $4.27 | $5.13 | $16.98 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.80 Median $4.68 Typical High $6.31 | Professional | None | $3.80 | $4.68 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $4.37 Median $7.76 Typical High $10.47 | Facility | None | $4.37 | $7.76 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.80 Median $5.62 Typical High $11.75 | Professional | None | $3.80 | $5.62 | $11.75 |
Molina Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $7.59 Typical High $11.22 | Facility | None | $4.27 | $7.59 | $11.22 |
Providence Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $9.12 | Professional | None | $4.27 | $4.27 | $9.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $15.85 | Professional | None | $4.68 | $4.68 | $15.85 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.63 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.42 | $0.43 | $0.43 |
Where California sits
The same service costs 3.4 times more in Texas than in Georgia. 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· 20th of 51
$4.90
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.