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 $4.68 Median $4.68 Typical High $8.13 | Facility | None | $4.68 | $4.68 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $7.76 Typical High $15.49 | Facility | None | $5.13 | $7.76 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.47 Typical High $12.30 | Professional | None | $4.37 | $4.47 | $12.30 |
Blue Shield Setting Facility Modifier None Typical Low $5.13 Median $5.62 Typical High $10.00 | Facility | None | $5.13 | $5.62 | $10.00 |
Blue Shield Setting Professional Modifier None Typical Low $4.68 Median $5.62 Typical High $12.59 | Professional | None | $4.68 | $5.62 | $12.59 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $5.13 | Professional | None | $3.72 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $8.51 Typical High $11.75 | Facility | None | $4.79 | $8.51 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.17 Median $5.37 Typical High $12.59 | Professional | None | $4.17 | $5.37 | $12.59 |
Providence Setting Facility Modifier None Typical Low $4.68 Median $8.32 Typical High $12.88 | Facility | None | $4.68 | $8.32 | $12.88 |
Providence Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | None | $4.68 | $4.68 | $5.50 |
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 $4.68 Median $4.68 Typical High $13.49 | Facility | None | $4.68 | $4.68 | $13.49 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $12.88 | Professional | None | $4.47 | $4.47 | $12.88 |
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 $2.34 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $2.34 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.93 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.93 | $0.93 | $0.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.47 | $0.47 | $0.47 |
Where California sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 7th of 51
$5.50
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.