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 $72.44 Median $74.13 Typical High $131.83 | Facility | None | $72.44 | $74.13 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | None | $72.44 | $74.13 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $85.11 Typical High $107.15 | Facility | None | $72.44 | $85.11 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $251.19 | Professional | None | $74.13 | $74.13 | $251.19 |
Blue Shield Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $112.20 | Facility | None | $75.86 | $95.50 | $112.20 |
Blue Shield Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $109.65 | Professional | None | $69.18 | $69.18 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $134.90 Typical High $181.97 | Facility | None | $75.86 | $134.90 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $75.86 | Professional | None | $56.23 | $69.18 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $204.17 | Professional | None | $66.07 | $85.11 | $204.17 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $194.98 | Facility | None | $72.44 | $109.65 | $194.98 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $199.53 | Professional | None | $29.51 | $74.13 | $199.53 |
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 $36.31 Median $37.15 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $15.49 | Professional | 53 · Discontinued | $14.45 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.76 |
Where California sits
The same service costs 1.6 times more in Hawaii 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· 26th of 51
$74.13
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.