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 $3.63 Median $3.72 Typical High $5.25 | Facility | None | $3.63 | $3.72 | $5.25 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $5.25 | Professional | None | $3.63 | $3.98 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.31 Median $3.98 Typical High $5.37 | Facility | None | $3.31 | $3.98 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.98 Median $3.31 Typical High $7.08 | Professional | None | $0.98 | $3.31 | $7.08 |
Blue Shield Setting Facility Modifier None Typical Low $3.55 Median $3.72 Typical High $5.37 | Facility | None | $3.55 | $3.72 | $5.37 |
Blue Shield Setting Professional Modifier None Typical Low $3.98 Median $4.68 Typical High $9.55 | Professional | None | $3.98 | $4.68 | $9.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.31 Median $3.98 Typical High $5.50 | Professional | None | $3.31 | $3.98 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $6.61 Typical High $9.12 | Facility | None | $3.80 | $6.61 | $9.12 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.31 Median $3.98 Typical High $9.77 | Professional | None | $3.31 | $3.98 | $9.77 |
Molina Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Providence Setting Facility Modifier None Typical Low $3.47 Median $5.50 Typical High $9.77 | Facility | None | $3.47 | $5.50 | $9.77 |
Providence Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.89 | Professional | None | $3.63 | $3.63 | $3.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
United Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
United Setting Professional Modifier None Typical Low $3.31 Median $3.55 Typical High $10.23 | Professional | None | $3.31 | $3.55 | $10.23 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | 52 · Reduced service | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.72 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 55 · Aftercare only | $0.55 | $0.55 | $0.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.36 | $0.37 | $0.37 |
Where California sits
The same service costs 2.5 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· 13th of 51
$3.89
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.