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 $7.76 Median $7.76 Typical High $14.79 | Facility | None | $7.76 | $7.76 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $8.51 Typical High $11.22 | Professional | None | $7.76 | $8.51 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $9.33 Typical High $11.48 | Facility | None | $8.13 | $9.33 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $19.50 | Professional | None | $8.13 | $8.51 | $19.50 |
Blue Shield Setting Facility Modifier None Typical Low $10.23 Median $15.14 Typical High $21.38 | Facility | None | $10.23 | $15.14 | $21.38 |
Blue Shield Setting Professional Modifier None Typical Low $7.76 Median $9.55 Typical High $21.88 | Professional | None | $7.76 | $9.55 | $21.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.08 Median $8.51 Typical High $11.75 | Professional | None | $7.08 | $8.51 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $14.13 Typical High $19.50 | Facility | None | $8.13 | $14.13 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.08 Median $9.77 Typical High $20.89 | Professional | None | $7.08 | $9.77 | $20.89 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Providence Setting Facility Modifier None Typical Low $7.76 Median $13.49 Typical High $20.89 | Facility | None | $7.76 | $13.49 | $20.89 |
Providence Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $13.80 | Professional | None | $7.76 | $7.76 | $13.80 |
Sutter Health Plus Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
United Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $28.18 | Professional | None | $8.13 | $8.13 | $28.18 |
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 $3.89 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.58 Typical High $1.58 | Professional | 53 · Discontinued | $1.55 | $1.58 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.78 | $0.79 | $0.79 |
Where California sits
The same service costs 2.6 times more in Texas 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· 24th of 51
$8.71
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.