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 $2.82 Median $2.88 Typical High $5.62 | Facility | None | $2.82 | $2.88 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $2.88 Typical High $3.98 | Professional | None | $2.82 | $2.88 | $3.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.02 Median $3.47 Typical High $4.27 | Facility | None | $3.02 | $3.47 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.16 Typical High $10.72 | Professional | None | $3.09 | $3.16 | $10.72 |
Blue Shield Setting Facility Modifier None Typical Low $3.72 Median $5.62 Typical High $7.94 | Facility | None | $3.72 | $5.62 | $7.94 |
Blue Shield Setting Professional Modifier None Typical Low $2.82 Median $3.47 Typical High $9.55 | Professional | None | $2.82 | $3.47 | $9.55 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.57 Median $3.16 Typical High $4.27 | Professional | None | $2.57 | $3.16 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $5.25 Typical High $7.08 | Facility | None | $2.95 | $5.25 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.57 Median $3.72 Typical High $7.94 | Professional | None | $2.57 | $3.72 | $7.94 |
Molina Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
Providence Setting Facility Modifier None Typical Low $2.88 Median $4.90 Typical High $8.13 | Facility | None | $2.88 | $4.90 | $8.13 |
Providence Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $5.62 | Professional | None | $2.82 | $2.82 | $5.62 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $11.48 | Professional | None | $3.09 | $3.09 | $11.48 |
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 $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.56 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Where California sits
The same service costs 2.0 times more in Wyoming 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· 12th of 51
$3.39
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.