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 $3.24 Median $3.24 Typical High $5.37 | Facility | None | $3.24 | $3.24 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $5.50 Typical High $11.22 | Facility | None | $3.55 | $5.50 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.39 Typical High $9.55 | Professional | None | $3.24 | $3.39 | $9.55 |
Blue Shield Setting Facility Modifier None Typical Low $3.02 Median $3.55 Typical High $8.71 | Facility | None | $3.02 | $3.55 | $8.71 |
Blue Shield Setting Professional Modifier None Typical Low $3.24 Median $3.89 Typical High $9.12 | Professional | None | $3.24 | $3.89 | $9.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.57 Median $3.55 Typical High $3.55 | Professional | None | $2.57 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $5.89 Typical High $8.13 | Facility | None | $3.39 | $5.89 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.88 Median $3.89 Typical High $9.12 | Professional | None | $2.88 | $3.89 | $9.12 |
Providence Setting Facility Modifier None Typical Low $3.24 Median $5.89 Typical High $9.12 | Facility | None | $3.24 | $5.89 | $9.12 |
Providence Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $7.08 | Professional | None | $3.24 | $3.24 | $7.08 |
Sutter Health Plus Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $10.72 | Facility | None | $3.24 | $3.24 | $10.72 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $8.71 | Professional | None | $3.24 | $3.24 | $8.71 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 54 · Surgery only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.32 | $0.33 | $0.33 |
Where California sits
The same service costs 1.7 times more in Arizona 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· 4th of 51
$3.89
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.