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 $1.51 Median $1.51 Typical High $2.75 | Facility | None | $1.51 | $1.51 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.62 Median $2.51 Typical High $5.25 | Facility | None | $1.62 | $2.51 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.05 Median $1.51 Typical High $4.68 | Professional | None | $1.05 | $1.51 | $4.68 |
Blue Shield Setting Facility Modifier None Typical Low $1.48 Median $1.55 Typical High $2.24 | Facility | None | $1.48 | $1.55 | $2.24 |
Blue Shield Setting Professional Modifier None Typical Low $1.51 Median $1.82 Typical High $4.27 | Professional | None | $1.51 | $1.82 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $2.75 Typical High $3.80 | Facility | None | $1.58 | $2.75 | $3.80 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.35 Median $1.82 Typical High $4.27 | Professional | None | $1.35 | $1.82 | $4.27 |
Molina Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Providence Setting Facility Modifier None Typical Low $1.51 Median $2.63 Typical High $4.07 | Facility | None | $1.51 | $2.63 | $4.07 |
Providence Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $2.82 | Professional | None | $1.51 | $1.51 | $2.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $5.13 | Facility | None | $1.51 | $1.51 | $5.13 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $4.07 | Professional | None | $1.51 | $1.51 | $4.07 |
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 $0.76 Median $0.78 Typical High $0.78 | Professional | 52 · Reduced service | $0.76 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.31 Typical High $0.31 | Professional | 53 · Discontinued | $0.30 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where California sits
The same service costs 1.7 times more in Arizona than in North Carolina. 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· 13th of 51
$1.66
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.