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 $2.29 Median $2.29 Typical High $4.07 | Facility | None | $2.29 | $2.29 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.51 Median $3.80 Typical High $7.59 | Facility | None | $2.51 | $3.80 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $2.29 Typical High $6.92 | Professional | None | $2.24 | $2.29 | $6.92 |
Blue Shield Setting Facility Modifier None Typical Low $2.69 Median $2.88 Typical High $5.37 | Facility | None | $2.69 | $2.88 | $5.37 |
Blue Shield Setting Professional Modifier None Typical Low $2.29 Median $2.82 Typical High $6.31 | Professional | None | $2.29 | $2.82 | $6.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.82 Median $2.51 Typical High $2.51 | Professional | None | $1.82 | $2.51 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $2.40 Median $4.17 Typical High $5.75 | Facility | None | $2.40 | $4.17 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | None | $2.45 | $2.45 | $2.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.04 Median $2.75 Typical High $6.46 | Professional | None | $2.04 | $2.75 | $6.46 |
Providence Setting Facility Modifier None Typical Low $2.29 Median $4.17 Typical High $6.46 | Facility | None | $2.29 | $4.17 | $6.46 |
Providence Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.88 | Professional | None | $2.29 | $2.29 | $2.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
United Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $6.92 | Professional | None | $2.24 | $2.24 | $6.92 |
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 $1.15 Median $1.15 Typical High $1.15 | Professional | 52 · Reduced service | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.23 |
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· 9th of 51
$2.75
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.