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 $56.23 Median $57.54 Typical High $91.20 | Facility | None | $56.23 | $57.54 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | None | $56.23 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $64.57 Typical High $85.11 | Facility | None | $54.95 | $64.57 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $117.49 | Professional | None | $52.48 | $54.95 | $117.49 |
Blue Shield Setting Facility Modifier None Typical Low $54.95 Median $56.23 Typical High $81.28 | Facility | None | $54.95 | $56.23 | $81.28 |
Blue Shield Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $91.20 | Professional | None | $56.23 | $56.23 | $91.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $74.13 | Professional | None | $56.23 | $56.23 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $104.71 Typical High $141.25 | Facility | None | $58.88 | $104.71 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | None | $56.23 | $56.23 | $66.07 |
Contra Costa Health Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $66.07 | Professional | None | $43.65 | $54.95 | $66.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $151.36 | Professional | None | $51.29 | $60.26 | $151.36 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $151.36 | Facility | None | $54.95 | $87.10 | $151.36 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $66.07 | Professional | None | $56.23 | $56.23 | $66.07 |
Sutter Health Plus Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $117.49 | Professional | None | $21.88 | $54.95 | $117.49 |
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 $28.18 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $28.18 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $5.75 |
Where California sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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· 29th of 51
$56.23
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.