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 $1.35 Median $1.58 Typical High $2.75 | Facility | None | $1.35 | $1.58 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $2.57 | Professional | None | $1.35 | $1.48 | $2.57 |
Ambetter Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $4.07 | Professional | None | $1.35 | $1.35 | $4.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.35 Median $1.58 Typical High $2.00 | Facility | None | $1.35 | $1.58 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $11.48 | Professional | None | $1.35 | $1.35 | $11.48 |
Blue Shield Setting Facility Modifier None Typical Low $1.78 Median $4.27 Typical High $5.62 | Facility | None | $1.78 | $4.27 | $5.62 |
Blue Shield Setting Professional Modifier None Typical Low $1.45 Median $1.78 Typical High $4.07 | Professional | None | $1.45 | $1.78 | $4.07 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.23 Median $1.48 Typical High $2.04 | Professional | None | $1.23 | $1.48 | $2.04 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $2.45 Typical High $3.39 | Facility | None | $1.35 | $2.45 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.23 Median $1.62 Typical High $3.63 | Professional | None | $1.23 | $1.62 | $3.63 |
Molina Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Providence Setting Facility Modifier None Typical Low $1.35 Median $2.04 Typical High $3.72 | Facility | None | $1.35 | $2.04 | $3.72 |
Providence Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.86 | Professional | None | $1.35 | $1.35 | $1.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
United Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $2.95 | Professional | None | $1.35 | $1.35 | $2.95 |
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 $0.68 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where California sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 17th of 51
$1.48
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.