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 $2.19 Median $2.19 Typical High $3.63 | Facility | None | $2.19 | $2.19 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.29 Typical High $3.02 | Professional | None | $2.19 | $2.29 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.00 Median $2.40 Typical High $3.24 | Facility | None | $2.00 | $2.40 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.09 Typical High $7.24 | Professional | None | $2.04 | $2.09 | $7.24 |
Blue Shield Setting Facility Modifier None Typical Low $2.04 Median $2.14 Typical High $3.09 | Facility | None | $2.04 | $2.14 | $3.09 |
Blue Shield Setting Professional Modifier None Typical Low $2.34 Median $2.88 Typical High $7.24 | Professional | None | $2.34 | $2.88 | $7.24 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $3.31 | Professional | None | $1.95 | $2.40 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $3.98 Typical High $5.50 | Facility | None | $2.29 | $3.98 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.95 Median $2.40 Typical High $6.17 | Professional | None | $1.95 | $2.40 | $6.17 |
Molina Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | None | $1.95 | $1.95 | $1.95 |
Providence Setting Facility Modifier None Typical Low $2.19 Median $3.98 Typical High $6.17 | Facility | None | $2.19 | $3.98 | $6.17 |
Providence Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.89 | Professional | None | $2.19 | $2.19 | $3.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
United Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $5.50 | Professional | None | $2.04 | $2.04 | $5.50 |
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 $1.10 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.10 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
Where California sits
Rates are fairly even across states for this service. 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
$2.34
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.