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 $1.58 Median $1.62 Typical High $3.24 | Facility | None | $1.58 | $1.62 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.70 Typical High $2.24 | Professional | None | $1.58 | $1.70 | $2.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.55 Median $1.82 Typical High $2.34 | Facility | None | $1.55 | $1.82 | $2.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.91 Median $1.55 Typical High $10.72 | Professional | None | $0.91 | $1.55 | $10.72 |
Blue Shield Setting Facility Modifier None Typical Low $2.09 Median $3.31 Typical High $4.47 | Facility | None | $2.09 | $3.31 | $4.47 |
Blue Shield Setting Professional Modifier None Typical Low $1.58 Median $1.95 Typical High $5.62 | Professional | None | $1.58 | $1.95 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $1.66 Median $2.95 Typical High $3.98 | Facility | None | $1.66 | $2.95 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.45 Median $1.91 Typical High $4.47 | Professional | None | $1.45 | $1.91 | $4.47 |
Molina Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Providence Setting Facility Modifier None Typical Low $1.58 Median $2.75 Typical High $4.57 | Facility | None | $1.58 | $2.75 | $4.57 |
Providence Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $3.47 | Professional | None | $1.58 | $1.58 | $3.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
United Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $6.03 | Professional | None | $1.55 | $1.55 | $6.03 |
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 $0.79 Median $0.81 Typical High $0.81 | Professional | 52 · Reduced service | $0.79 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where California sits
The same service costs 3.3 times more in Texas 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· 30th of 51
$1.70
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.