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 $18.20 Median $18.20 Typical High $33.11 | Facility | None | $18.20 | $18.20 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | None | $18.20 | $18.20 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $30.20 Typical High $61.66 | Facility | None | $19.50 | $30.20 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $18.20 Typical High $47.86 | Professional | None | $17.78 | $18.20 | $47.86 |
Blue Shield Setting Facility Modifier None Typical Low $21.38 Median $22.39 Typical High $45.71 | Facility | None | $21.38 | $22.39 | $45.71 |
Blue Shield Setting Professional Modifier None Typical Low $18.20 Median $21.88 Typical High $54.95 | Professional | None | $18.20 | $21.88 | $54.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $16.22 Median $19.95 Typical High $26.92 | Professional | None | $16.22 | $19.95 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $33.11 Typical High $45.71 | Facility | None | $18.62 | $33.11 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Kaiser Permanente Setting Professional Modifier None Typical Low $16.22 Median $21.88 Typical High $47.86 | Professional | None | $16.22 | $21.88 | $47.86 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $32.36 Typical High $50.12 | Facility | None | $18.20 | $32.36 | $50.12 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $107.15 | Facility | None | $18.20 | $18.20 | $107.15 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $57.54 | Professional | None | $18.20 | $18.20 | $57.54 |
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 $9.12 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.69 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | JZ · No drug discarded | $18.20 | $18.20 | $18.20 |
Where California sits
The same service costs 1.6 times more in Arizona than in North Dakota. 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
$21.38
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.