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 $1.26 Median $1.26 Typical High $2.29 | Facility | None | $1.26 | $1.26 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.45 Median $2.24 Typical High $4.47 | Facility | None | $1.45 | $2.24 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.12 Median $1.38 Typical High $3.02 | Professional | None | $1.12 | $1.38 | $3.02 |
Blue Shield Setting Facility Modifier None Typical Low $1.45 Median $1.58 Typical High $2.63 | Facility | None | $1.45 | $1.58 | $2.63 |
Blue Shield Setting Professional Modifier None Typical Low $1.26 Median $1.51 Typical High $3.39 | Professional | None | $1.26 | $1.51 | $3.39 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.00 Median $1.38 Typical High $1.38 | Professional | None | $1.00 | $1.38 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $2.29 Typical High $3.16 | Facility | None | $1.29 | $2.29 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | None | $1.26 | $1.26 | $1.26 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.12 Median $1.62 Typical High $3.31 | Professional | None | $1.12 | $1.62 | $3.31 |
Molina Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Providence Setting Facility Modifier None Typical Low $1.26 Median $1.91 Typical High $3.31 | Facility | None | $1.26 | $1.91 | $3.31 |
Providence Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.82 | Professional | None | $1.26 | $1.26 | $1.82 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
United Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $3.55 | Facility | None | $1.26 | $1.26 | $3.55 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $3.80 | Professional | None | $1.38 | $1.38 | $3.80 |
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 $0.63 Median $0.63 Typical High $0.63 | Professional | 52 · Reduced service | $0.63 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 53 · Discontinued | $0.25 | $0.25 | $0.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 55 · Aftercare only | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where California sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 9th 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.