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 $3.39 Median $3.39 Typical High $12.30 | Facility | None | $3.39 | $3.39 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.72 Typical High $5.50 | Professional | None | $3.39 | $3.72 | $5.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.63 Median $5.01 Typical High $36.31 | Facility | None | $3.63 | $5.01 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $66.07 | Professional | None | $30.90 | $30.90 | $66.07 |
Blue Shield Setting Facility Modifier None Typical Low $4.79 Median $20.89 Typical High $27.54 | Facility | None | $4.79 | $20.89 | $27.54 |
Blue Shield Setting Professional Modifier None Typical Low $3.39 Median $4.07 Typical High $14.13 | Professional | None | $3.39 | $4.07 | $14.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.02 Median $3.72 Typical High $5.01 | Professional | None | $3.02 | $3.72 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $6.17 Typical High $8.32 | Facility | None | $3.39 | $6.17 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.02 Median $19.05 Typical High $53.70 | Professional | None | $3.02 | $19.05 | $53.70 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Providence Setting Facility Modifier None Typical Low $3.39 Median $6.31 Typical High $11.75 | Facility | None | $3.39 | $6.31 | $11.75 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $7.24 | Professional | None | $3.39 | $3.39 | $7.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $81.28 | Professional | None | $30.90 | $32.36 | $81.28 |
5 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 $1.70 Median $1.70 Typical High $1.70 | Professional | 52 · Reduced service | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.51 Typical High $0.51 | Professional | 55 · Aftercare only | $0.50 | $0.51 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.34 |
Ambetter Setting Professional Modifier JW · Drug discarded Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | JW · Drug discarded | $3.39 | $3.39 | $3.39 |
Where California sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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· 25th 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.