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 $100.00 | Facility | None | $63.10 | $63.10 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $134.90 | Professional | None | $63.10 | $66.07 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $51.29 Median $69.18 Typical High $93.33 | Facility | None | $51.29 | $69.18 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $51.29 Typical High $131.83 | Professional | None | $26.30 | $51.29 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $46.77 Median $54.95 Typical High $109.65 | Facility | None | $46.77 | $54.95 | $109.65 |
Blue Shield Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $151.36 | Professional | None | $63.10 | $74.13 | $151.36 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $208.93 | Professional | None | $138.04 | $181.97 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $102.33 Typical High $154.88 | Facility | None | $51.29 | $102.33 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $186.21 | Professional | None | $83.18 | $151.36 | $186.21 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $91.20 Typical High $154.88 | Facility | None | $51.29 | $91.20 | $154.88 |
Providence Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $125.89 | Professional | None | $51.29 | $51.29 | $125.89 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $173.78 | Professional | None | $63.10 | $63.10 | $173.78 |
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 $31.62 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $31.62 | $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 $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
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 3.0 times more in Kansas than in South Carolina. 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· 23rd of 51
$63.10
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.