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 $102.33 Median $102.33 Typical High $186.21 | Facility | None | $102.33 | $102.33 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $109.65 Typical High $123.03 | Facility | None | $0.03 | $109.65 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $104.71 Typical High $190.55 | Professional | None | $27.54 | $104.71 | $190.55 |
Blue Shield Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $123.03 | Facility | None | $70.79 | $100.00 | $123.03 |
Blue Shield Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $295.12 | Professional | None | $109.65 | $128.82 | $295.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $162.18 | Professional | None | $107.15 | $141.25 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $218.78 Typical High $331.13 | Facility | None | $107.15 | $218.78 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Molina Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Providence Setting Facility Modifier None Typical Low $15.85 Median $144.54 Typical High $288.40 | Facility | None | $15.85 | $144.54 | $288.40 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $107.15 Typical High $107.15 | Professional | None | $64.57 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $275.42 | Professional | None | $123.03 | $123.03 | $275.42 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where California sits
The same service costs 3.9 times more in Alaska than in Montana. 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· 46th of 51
$105
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.