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 $2.95 Median $2.95 Typical High $5.37 | Facility | None | $2.95 | $2.95 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $3.16 Typical High $3.55 | Facility | None | $0.03 | $3.16 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $8.51 | Professional | None | $3.02 | $3.02 | $8.51 |
Blue Shield Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
Blue Shield Setting Professional Modifier None Typical Low $2.24 Median $2.63 Typical High $5.89 | Professional | None | $2.24 | $2.63 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $4.37 Typical High $6.61 | Facility | None | $2.19 | $4.37 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Providence Setting Facility Modifier None Typical Low $2.19 Median $4.27 Typical High $6.61 | Facility | None | $2.19 | $4.27 | $6.61 |
Providence Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.29 | Professional | None | $2.19 | $2.19 | $2.29 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $8.91 | Professional | None | $3.55 | $3.55 | $8.91 |
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 $1.48 Median $1.48 Typical High $1.48 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where California sits
The same service costs 1.6 times more in Idaho than in Ohio. 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· 37th of 51
$3.02
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.