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 $42.66 Median $42.66 Typical High $74.13 | Facility | None | $42.66 | $42.66 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $144.54 | Facility | None | $46.77 | $70.79 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $100.00 | Professional | None | $32.36 | $40.74 | $100.00 |
Blue Shield Setting Facility Modifier None Typical Low $45.71 Median $51.29 Typical High $100.00 | Facility | None | $45.71 | $51.29 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $117.49 | Professional | None | $42.66 | $51.29 | $117.49 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $38.02 Median $46.77 Typical High $64.57 | Professional | None | $38.02 | $46.77 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $77.62 Typical High $107.15 | Facility | None | $44.67 | $77.62 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Contra Costa Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $114.82 | Professional | None | $38.02 | $51.29 | $114.82 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $77.62 Typical High $120.23 | Facility | None | $42.66 | $77.62 | $120.23 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $75.86 | Professional | None | $42.66 | $42.66 | $75.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $134.90 | Facility | None | $42.66 | $42.66 | $134.90 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $114.82 | Professional | None | $40.74 | $40.74 | $114.82 |
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 $21.38 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.27 |
Where California sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 9th of 51
$47.86
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.