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 $31.62 Median $32.36 Typical High $57.54 | Facility | None | $31.62 | $32.36 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $33.88 Typical High $43.65 | Professional | None | $31.62 | $33.88 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $36.31 Typical High $46.77 | Facility | None | $31.62 | $36.31 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $31.62 Typical High $69.18 | Professional | None | $19.50 | $31.62 | $69.18 |
Blue Shield Setting Facility Modifier None Typical Low $44.67 Median $57.54 Typical High $79.43 | Facility | None | $44.67 | $57.54 | $79.43 |
Blue Shield Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $100.00 | Professional | None | $31.62 | $38.02 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $57.54 Typical High $79.43 | Facility | None | $33.11 | $57.54 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $38.02 Typical High $85.11 | Professional | None | $28.84 | $38.02 | $85.11 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $47.86 Typical High $85.11 | Facility | None | $31.62 | $47.86 | $85.11 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $57.54 | Professional | None | $31.62 | $31.62 | $57.54 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $128.82 | Professional | None | $31.62 | $31.62 | $128.82 |
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 $15.85 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.31 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.24 |
Where California sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 19th of 51
$33.88
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.