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 $6.61 Median $6.61 Typical High $11.75 | Facility | None | $6.61 | $6.61 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.61 Typical High $8.32 | Professional | None | $6.31 | $6.61 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.61 Median $7.76 Typical High $9.77 | Facility | None | $6.61 | $7.76 | $9.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $6.76 Typical High $9.12 | Professional | None | $2.09 | $6.76 | $9.12 |
Blue Shield Setting Facility Modifier None Typical Low $6.76 Median $7.08 Typical High $9.77 | Facility | None | $6.76 | $7.08 | $9.77 |
Blue Shield Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $10.00 | Professional | None | $6.61 | $6.61 | $10.00 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $0.95 | Professional | None | $0.63 | $0.63 | $0.95 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $13.49 Typical High $20.42 | Facility | None | $6.76 | $13.49 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $8.91 Typical High $12.88 | Professional | None | $6.03 | $8.91 | $12.88 |
Molina Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
Providence Setting Facility Modifier None Typical Low $1.55 Median $9.33 Typical High $18.20 | Facility | None | $1.55 | $9.33 | $18.20 |
Providence Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
United Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $2.40 Median $6.61 Typical High $12.59 | Professional | None | $2.40 | $6.61 | $12.59 |
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 $3.24 Median $3.31 Typical High $3.39 | Professional | 52 · Reduced service | $3.24 | $3.31 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.32 Typical High $1.35 | Professional | 53 · Discontinued | $1.29 | $1.32 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $0.98 Typical High $1.00 | Professional | 55 · Aftercare only | $0.98 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.66 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.65 | $0.66 | $0.68 |
Where California sits
The same service costs 15.5 times more in Alaska than in Hawaii. 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· 8th of 51
$6.76
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.