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 $0.39 Median $0.39 Typical High $0.71 | Facility | None | $0.39 | $0.39 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $0.42 Typical High $0.47 | Facility | None | $0.03 | $0.42 | $0.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.28 Median $0.40 Typical High $0.93 | Professional | None | $0.28 | $0.40 | $0.93 |
Blue Shield Setting Facility Modifier None Typical Low $0.40 Median $0.40 Typical High $0.60 | Facility | None | $0.40 | $0.40 | $0.60 |
Blue Shield Setting Professional Modifier None Typical Low $0.62 Median $0.71 Typical High $1.62 | Professional | None | $0.62 | $0.71 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $0.41 Median $0.81 Typical High $1.23 | Facility | None | $0.41 | $0.81 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Molina Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | None | $0.45 | $0.45 | $0.45 |
Providence Setting Facility Modifier None Typical Low $0.39 Median $0.56 Typical High $1.10 | Facility | None | $0.39 | $0.56 | $1.10 |
Providence Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
United Setting Facility Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
United Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $2.45 | Professional | None | $1.05 | $1.05 | $2.45 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where California sits
The same service costs 2.7 times more in Mississippi than in Arkansas. 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· 40th of 51
$0.41
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.