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 $32.36 Median $32.36 Typical High $57.54 | Facility | None | $32.36 | $32.36 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $35.48 Typical High $48.98 | Professional | None | $32.36 | $35.48 | $48.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $34.67 Median $53.70 Typical High $112.20 | Facility | None | $34.67 | $53.70 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $31.62 Typical High $83.18 | Professional | None | $27.54 | $31.62 | $83.18 |
Blue Shield Setting Facility Modifier None Typical Low $37.15 Median $38.90 Typical High $74.13 | Facility | None | $37.15 | $38.90 | $74.13 |
Blue Shield Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $87.10 | Professional | None | $32.36 | $38.90 | $87.10 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $48.98 | Professional | None | $28.84 | $35.48 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $58.88 Typical High $81.28 | Facility | None | $33.88 | $58.88 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $87.10 | Professional | None | $28.84 | $38.02 | $87.10 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $57.54 Typical High $89.13 | Facility | None | $32.36 | $57.54 | $89.13 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $39.81 | Professional | None | $32.36 | $32.36 | $39.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $97.72 | Facility | None | $32.36 | $32.36 | $97.72 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $95.50 | Professional | None | $31.62 | $31.62 | $95.50 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.79 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where California sits
The same service costs 2.0 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· 9th of 51
$37.15
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.