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 $4.47 Median $4.57 Typical High $7.59 | Facility | None | $4.47 | $4.57 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.57 Typical High $5.01 | Professional | None | $4.47 | $4.57 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.17 Median $4.90 Typical High $6.76 | Facility | None | $4.17 | $4.90 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $8.91 | Professional | None | $4.17 | $4.17 | $8.91 |
Blue Shield Setting Facility Modifier None Typical Low $6.31 Median $10.23 Typical High $14.45 | Facility | None | $6.31 | $10.23 | $14.45 |
Blue Shield Setting Professional Modifier None Typical Low $4.47 Median $5.50 Typical High $17.38 | Professional | None | $4.47 | $5.50 | $17.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.07 Median $5.01 Typical High $6.76 | Professional | None | $4.07 | $5.01 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $8.32 Typical High $11.22 | Facility | None | $4.68 | $8.32 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.07 Median $5.25 Typical High $12.59 | Professional | None | $4.07 | $5.25 | $12.59 |
Molina Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Providence Setting Facility Modifier None Typical Low $4.47 Median $8.51 Typical High $13.80 | Facility | None | $4.47 | $8.51 | $13.80 |
Providence Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.50 | Professional | None | $4.47 | $4.47 | $5.50 |
Sutter Health Plus Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $16.22 | Professional | None | $4.17 | $4.17 | $16.22 |
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 $2.24 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.24 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.89 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.45 | $0.46 | $0.46 |
Where California sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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· 27th of 51
$4.68
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.