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 $1.74 Median $1.74 Typical High $2.88 | Facility | None | $1.74 | $1.74 | $2.88 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.86 Median $2.95 Typical High $5.89 | Facility | None | $1.86 | $2.95 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.55 Median $1.74 Typical High $3.98 | Professional | None | $1.55 | $1.74 | $3.98 |
Blue Shield Setting Facility Modifier None Typical Low $1.91 Median $2.04 Typical High $3.63 | Facility | None | $1.91 | $2.04 | $3.63 |
Blue Shield Setting Professional Modifier None Typical Low $1.74 Median $2.09 Typical High $4.68 | Professional | None | $1.74 | $2.09 | $4.68 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.38 Median $1.91 Typical High $1.91 | Professional | None | $1.38 | $1.91 | $1.91 |
Cigna Setting Facility Modifier None Typical Low $1.78 Median $3.16 Typical High $4.27 | Facility | None | $1.78 | $3.16 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.55 Median $2.09 Typical High $4.57 | Professional | None | $1.55 | $2.09 | $4.57 |
Molina Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Providence Setting Facility Modifier None Typical Low $1.74 Median $3.09 Typical High $4.79 | Facility | None | $1.74 | $3.09 | $4.79 |
Providence Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.29 | Professional | None | $1.74 | $1.74 | $2.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $4.68 | Facility | None | $1.74 | $1.74 | $4.68 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $4.79 | Professional | None | $1.74 | $1.74 | $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 $0.85 Median $0.87 Typical High $0.87 | Professional | 52 · Reduced service | $0.85 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.35 Typical High $0.35 | Professional | 53 · Discontinued | $0.34 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where California sits
The same service costs 1.8 times more in Alaska than in Virginia. 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· 11th 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.