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 $1.10 Median $1.10 Typical High $2.00 | Facility | None | $1.10 | $1.10 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $1.10 Median $1.20 Typical High $2.09 | Professional | None | $1.10 | $1.20 | $2.09 |
Ambetter Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.10 Median $1.29 Typical High $1.62 | Facility | None | $1.10 | $1.29 | $1.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.34 | Professional | None | $1.10 | $1.10 | $2.34 |
Anthem BCBS Setting Professional Modifier KO · Single-drug unit dose Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | KO · Single-drug unit dose | $1.10 | $1.10 | $1.10 |
Blue Shield Setting Facility Modifier None Typical Low $1.45 Median $4.37 Typical High $5.37 | Facility | None | $1.45 | $4.37 | $5.37 |
Blue Shield Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $2.57 | Professional | None | $1.10 | $1.10 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $1.12 Median $2.00 Typical High $2.75 | Facility | None | $1.12 | $2.00 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $4.37 | Professional | None | $1.10 | $1.10 | $4.37 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.07 Median $1.35 Typical High $1.48 | Professional | None | $1.07 | $1.35 | $1.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.98 Median $1.20 Typical High $2.95 | Professional | None | $0.98 | $1.20 | $2.95 |
Molina Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Providence Setting Facility Modifier None Typical Low $1.10 Median $2.04 Typical High $3.47 | Facility | None | $1.10 | $2.04 | $3.47 |
Providence Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $4.37 | Professional | None | $1.10 | $1.10 | $4.37 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
United Setting Professional Modifier None Typical Low $0.72 Median $1.10 Typical High $2.24 | Professional | None | $0.72 | $1.10 | $2.24 |
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 $0.55 Median $0.55 Typical High $0.58 | Professional | 52 · Reduced service | $0.55 | $0.55 | $0.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.23 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.16 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.16 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.12 |
Where California sits
The same service costs 4.3 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· 47th of 51
$1.10
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.