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 $0.58 Median $0.59 Typical High $1.23 | Facility | None | $0.58 | $0.59 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.63 Typical High $0.85 | Professional | None | $0.56 | $0.63 | $0.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.71 Median $1.12 Typical High $2.34 | Facility | None | $0.71 | $1.12 | $2.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.68 Median $0.71 Typical High $2.40 | Professional | None | $0.68 | $0.71 | $2.40 |
Blue Shield Setting Facility Modifier None Typical Low $0.78 Median $2.34 Typical High $3.55 | Facility | None | $0.78 | $2.34 | $3.55 |
Blue Shield Setting Professional Modifier None Typical Low $0.58 Median $0.71 Typical High $1.95 | Professional | None | $0.58 | $0.71 | $1.95 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.52 Median $0.65 Typical High $0.87 | Professional | None | $0.52 | $0.65 | $0.87 |
Cigna Setting Facility Modifier None Typical Low $0.62 Median $1.07 Typical High $1.45 | Facility | None | $0.62 | $1.07 | $1.45 |
Cigna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | None | $0.58 | $0.58 | $0.58 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | None | $0.78 | $0.78 | $0.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.52 Median $0.79 Typical High $1.62 | Professional | None | $0.52 | $0.79 | $1.62 |
Molina Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | None | $0.56 | $0.56 | $0.56 |
Providence Setting Facility Modifier None Typical Low $0.59 Median $1.05 Typical High $1.62 | Facility | None | $0.59 | $1.05 | $1.62 |
Providence Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $1.26 | Professional | None | $0.58 | $0.58 | $1.26 |
United Setting Facility Modifier None Typical Low $0.58 Median $0.58 Typical High $7.41 | Facility | None | $0.58 | $0.58 | $7.41 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.86 | Professional | None | $0.68 | $0.68 | $1.86 |
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 $0.28 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.28 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 54 · Surgery only | $0.44 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where California sits
The same service costs 4.1 times more in Wyoming than in Delaware. 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
$0.76
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.