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 $2.63 Median $2.63 Typical High $4.79 | Facility | None | $2.63 | $2.63 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.88 Median $4.57 Typical High $9.12 | Facility | None | $2.88 | $4.57 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.56 Median $2.69 Typical High $5.25 | Professional | None | $0.56 | $2.69 | $5.25 |
Blue Shield Setting Facility Modifier None Typical Low $2.69 Median $2.88 Typical High $4.79 | Facility | None | $2.69 | $2.88 | $4.79 |
Blue Shield Setting Professional Modifier None Typical Low $2.63 Median $3.09 Typical High $6.17 | Professional | None | $2.63 | $3.09 | $6.17 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.63 Median $3.47 Typical High $3.98 | Professional | None | $2.63 | $3.47 | $3.98 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $5.50 Typical High $8.32 | Facility | None | $2.69 | $5.50 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $7.94 | Professional | None | $3.98 | $5.01 | $7.94 |
Providence Setting Facility Modifier None Typical Low $2.69 Median $3.80 Typical High $7.41 | Facility | None | $2.69 | $3.80 | $7.41 |
Providence Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $6.76 | Facility | None | $2.75 | $2.75 | $6.76 |
United Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $7.24 | Professional | None | $2.63 | $2.63 | $7.24 |
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 $1.32 Median $1.32 Typical High $1.32 | Professional | 52 · Reduced service | $1.32 | $1.32 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.27 |
Where California sits
The same service costs 1.8 times more in Arizona than in Hawaii. 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· 23rd of 51
$2.69
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.