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 $2.57 Median $2.57 Typical High $4.07 | Facility | None | $2.57 | $2.57 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.82 Median $4.27 Typical High $8.91 | Facility | None | $2.82 | $4.27 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.45 Typical High $5.75 | Professional | None | $2.19 | $2.45 | $5.75 |
Blue Shield Setting Facility Modifier None Typical Low $2.75 Median $3.09 Typical High $5.37 | Facility | None | $2.75 | $3.09 | $5.37 |
Blue Shield Setting Professional Modifier None Typical Low $2.57 Median $3.09 Typical High $6.92 | Professional | None | $2.57 | $3.09 | $6.92 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.04 Median $2.82 Typical High $2.82 | Professional | None | $2.04 | $2.82 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $4.68 Typical High $6.46 | Facility | None | $2.69 | $4.68 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.29 Median $2.95 Typical High $6.92 | Professional | None | $2.29 | $2.95 | $6.92 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Providence Setting Facility Modifier None Typical Low $2.57 Median $4.68 Typical High $7.24 | Facility | None | $2.57 | $4.68 | $7.24 |
Providence Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $3.47 | Professional | None | $2.57 | $2.57 | $3.47 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $7.08 | Facility | None | $2.57 | $2.57 | $7.08 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $6.76 | Professional | None | $2.45 | $2.45 | $6.76 |
5 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 $1.29 Median $1.29 Typical High $1.29 | Professional | 52 · Reduced service | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 54 · Surgery only | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.26 |
Where California sits
The same service costs 1.8 times more in Alaska than in Maryland. 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
$2.82
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.