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 $0.60 Median $0.60 Typical High $1.02 | Facility | None | $0.60 | $0.60 | $1.02 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.62 Median $0.72 Typical High $0.89 | Facility | None | $0.62 | $0.72 | $0.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.65 Typical High $4.79 | Professional | None | $0.62 | $0.65 | $4.79 |
Blue Shield Setting Facility Modifier None Typical Low $0.83 Median $1.58 Typical High $2.14 | Facility | None | $0.83 | $1.58 | $2.14 |
Blue Shield Setting Professional Modifier None Typical Low $0.60 Median $0.72 Typical High $2.09 | Professional | None | $0.60 | $0.72 | $2.09 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.54 Median $0.66 Typical High $0.89 | Professional | None | $0.54 | $0.66 | $0.89 |
Cigna Setting Facility Modifier None Typical Low $0.60 Median $1.10 Typical High $1.51 | Facility | None | $0.60 | $1.10 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | None | $0.68 | $0.68 | $0.68 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.54 Median $0.76 Typical High $1.66 | Professional | None | $0.54 | $0.76 | $1.66 |
Molina Setting Professional Modifier None Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | None | $0.81 | $0.81 | $0.81 |
Providence Setting Facility Modifier None Typical Low $0.60 Median $1.12 Typical High $1.91 | Facility | None | $0.60 | $1.12 | $1.91 |
Providence Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $1.29 | Professional | None | $0.60 | $0.60 | $1.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | None | $1.70 | $1.70 | $1.70 |
United Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Facility | None | $2.88 | $2.88 | $2.88 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.66 Typical High $2.00 | Professional | None | $0.62 | $0.66 | $2.00 |
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 $0.30 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where California sits
The same service costs 3.4 times more in Wyoming than in Delaware. 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· 12th of 51
$0.71
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.