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 $5.62 Median $5.62 Typical High $10.72 | Facility | None | $5.62 | $5.62 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.89 Median $6.76 Typical High $8.32 | Facility | None | $5.89 | $6.76 | $8.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $6.17 Typical High $29.51 | Professional | None | $5.89 | $6.17 | $29.51 |
Blue Shield Setting Facility Modifier None Typical Low $7.41 Median $16.60 Typical High $21.38 | Facility | None | $7.41 | $16.60 | $21.38 |
Blue Shield Setting Professional Modifier None Typical Low $5.62 Median $6.76 Typical High $20.42 | Professional | None | $5.62 | $6.76 | $20.42 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.01 Median $6.17 Typical High $8.32 | Professional | None | $5.01 | $6.17 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $10.23 Typical High $14.13 | Facility | None | $5.75 | $10.23 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.01 Median $7.08 Typical High $15.85 | Professional | None | $5.01 | $7.08 | $15.85 |
Molina Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Providence Setting Facility Modifier None Typical Low $5.62 Median $10.47 Typical High $15.85 | Facility | None | $5.62 | $10.47 | $15.85 |
Providence Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $12.02 | Professional | None | $5.62 | $5.62 | $12.02 |
Sutter Health Plus Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $14.79 | Professional | None | $5.89 | $5.89 | $14.79 |
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 $2.82 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.85 Typical High $0.85 | Professional | 55 · Aftercare only | $0.83 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Where California sits
The same service costs 3.2 times more in Oklahoma than in North Dakota. 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· 14th of 51
$6.46
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.