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 $36.31 Median $36.31 Typical High $83.18 | Facility | None | $36.31 | $36.31 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $43.65 Typical High $53.70 | Facility | None | $37.15 | $43.65 | $53.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $37.15 Typical High $72.44 | Professional | None | $7.94 | $37.15 | $72.44 |
Blue Shield Setting Facility Modifier None Typical Low $43.65 Median $44.67 Typical High $61.66 | Facility | None | $43.65 | $44.67 | $61.66 |
Blue Shield Setting Professional Modifier None Typical Low $36.31 Median $44.67 Typical High $112.20 | Professional | None | $36.31 | $44.67 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $112.20 | Facility | None | $37.15 | $74.13 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $52.48 Typical High $100.00 | Facility | None | $14.45 | $52.48 | $100.00 |
Providence Setting Professional Modifier None Typical Low $19.05 Median $37.15 Typical High $37.15 | Professional | None | $19.05 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $158.49 | Professional | None | $36.31 | $36.31 | $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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where California sits
The same service costs 8.1 times more in Kansas than in Hawaii. 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
$37.15
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.