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 $1.58 Median $1.58 Typical High $2.57 | Facility | None | $1.58 | $1.58 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.70 Median $2.63 Typical High $5.50 | Facility | None | $1.70 | $2.63 | $5.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.20 Median $1.58 Typical High $3.55 | Professional | None | $1.20 | $1.58 | $3.55 |
Blue Shield Setting Facility Modifier None Typical Low $1.91 Median $2.04 Typical High $3.55 | Facility | None | $1.91 | $2.04 | $3.55 |
Blue Shield Setting Professional Modifier None Typical Low $1.58 Median $1.91 Typical High $4.27 | Professional | None | $1.58 | $1.91 | $4.27 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.26 Median $1.74 Typical High $1.74 | Professional | None | $1.26 | $1.74 | $1.74 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $2.88 Typical High $3.98 | Facility | None | $1.62 | $2.88 | $3.98 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.41 Median $1.91 Typical High $4.27 | Professional | None | $1.41 | $1.91 | $4.27 |
Molina Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | None | $1.55 | $1.55 | $1.55 |
Providence Setting Facility Modifier None Typical Low $1.58 Median $2.40 Typical High $4.27 | Facility | None | $1.58 | $2.40 | $4.27 |
Providence Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $2.24 | Professional | None | $1.58 | $1.58 | $2.24 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $4.27 | Facility | None | $1.58 | $1.58 | $4.27 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $4.79 | Professional | None | $1.58 | $1.58 | $4.79 |
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 $0.79 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where California sits
The same service costs 1.7 times more in Arizona than in Alabama. 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· 8th of 51
$1.95
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.