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 $28.18 Median $28.18 Typical High $51.29 | Facility | None | $28.18 | $28.18 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.84 | Professional | None | $28.18 | $28.18 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $39.81 Typical High $102.33 | Facility | None | $28.84 | $39.81 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $87.10 | Professional | None | $28.84 | $28.84 | $87.10 |
Blue Shield Setting Facility Modifier None Typical Low $28.84 Median $32.36 Typical High $61.66 | Facility | None | $28.84 | $32.36 | $61.66 |
Blue Shield Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $81.28 | Professional | None | $30.90 | $35.48 | $81.28 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $42.66 | Professional | None | $28.18 | $37.15 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $57.54 Typical High $87.10 | Facility | None | $28.84 | $57.54 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $28.84 Median $61.66 Typical High $87.10 | Professional | None | $28.84 | $61.66 | $87.10 |
Providence Setting Facility Modifier None Typical Low $28.18 Median $40.74 Typical High $77.62 | Facility | None | $28.18 | $40.74 | $77.62 |
Providence Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $91.20 | Professional | None | $33.88 | $33.88 | $91.20 |
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 $14.13 Median $14.13 Typical High $14.45 | Professional | 52 · Reduced service | $14.13 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $5.75 | Professional | 53 · Discontinued | $5.62 | $5.62 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.88 |
Where California sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 31st of 51
$30.90
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.