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 $63.10 Median $63.10 Typical High $102.33 | Facility | None | $63.10 | $63.10 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $67.61 Typical High $93.33 | Professional | None | $63.10 | $67.61 | $93.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $104.71 Typical High $213.80 | Facility | None | $67.61 | $104.71 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $138.04 | Professional | None | $61.66 | $64.57 | $138.04 |
Blue Shield Setting Facility Modifier None Typical Low $52.48 Median $64.57 Typical High $107.15 | Facility | None | $52.48 | $64.57 | $107.15 |
Blue Shield Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $165.96 | Professional | None | $63.10 | $75.86 | $165.96 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $93.33 | Professional | None | $56.23 | $69.18 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $114.82 Typical High $154.88 | Facility | None | $63.10 | $114.82 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Contra Costa Health Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $165.96 | Professional | None | $56.23 | $74.13 | $165.96 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $165.96 | Facility | None | $61.66 | $107.15 | $165.96 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $70.79 | Professional | None | $63.10 | $63.10 | $70.79 |
Sutter Health Plus Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $158.49 | Facility | None | $63.10 | $63.10 | $158.49 |
United Setting Professional Modifier None Typical Low $61.66 Median $66.07 Typical High $158.49 | Professional | None | $61.66 | $66.07 | $158.49 |
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 $30.90 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.90 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Where California sits
The same service costs 9.3 times more in Alabama 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· 10th of 51
$69.18
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.