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 $1.86 Median $1.95 Typical High $2.45 | Facility | None | $1.86 | $1.95 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $1.07 Median $2.04 Typical High $2.69 | Professional | None | $1.07 | $2.04 | $2.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.95 Median $2.09 Typical High $2.88 | Facility | None | $0.95 | $2.09 | $2.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.95 | Professional | None | $0.93 | $0.93 | $1.95 |
Blue Shield Setting Facility Modifier None Typical Low $0.93 Median $1.05 Typical High $2.75 | Facility | None | $0.93 | $1.05 | $2.75 |
Blue Shield Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.75 | Professional | None | $1.82 | $1.82 | $2.75 |
Cigna Setting Facility Modifier None Typical Low $2.00 Median $3.55 Typical High $4.79 | Facility | None | $2.00 | $3.55 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $0.93 Median $1.95 Typical High $1.95 | Professional | None | $0.93 | $1.95 | $1.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.41 Median $1.78 Typical High $1.95 | Professional | None | $1.41 | $1.78 | $1.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.74 Median $2.34 Typical High $5.50 | Professional | None | $1.74 | $2.34 | $5.50 |
Molina Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Providence Setting Facility Modifier None Typical Low $1.91 Median $2.95 Typical High $5.25 | Facility | None | $1.91 | $2.95 | $5.25 |
Providence Setting Professional Modifier None Typical Low $0.93 Median $1.95 Typical High $2.04 | Professional | None | $0.93 | $1.95 | $2.04 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
United Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $0.59 Median $0.91 Typical High $2.19 | Professional | None | $0.59 | $0.91 | $2.19 |
2 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 55 · Aftercare only Typical Low $0.14 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.14 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.19 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.09 | $0.19 | $0.20 |
Where California sits
The same service costs 2.3 times more in Arkansas than in North Carolina. 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· 33rd of 51
$1.82
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.