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 $12.30 Median $12.30 Typical High $14.13 | Facility | None | $12.30 | $12.30 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $12.30 | Professional | None | $8.13 | $12.30 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.94 Median $13.49 Typical High $18.20 | Facility | None | $7.94 | $13.49 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $48.98 | Professional | None | $7.76 | $7.76 | $48.98 |
Blue Shield Setting Facility Modifier None Typical Low $16.22 Median $26.30 Typical High $41.69 | Facility | None | $16.22 | $26.30 | $41.69 |
Blue Shield Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $26.30 | Professional | None | $12.30 | $12.30 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $22.39 Typical High $30.90 | Facility | None | $12.88 | $22.39 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $15.49 | Professional | None | $12.30 | $12.30 | $15.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.88 Median $16.22 Typical High $17.78 | Professional | None | $12.88 | $16.22 | $17.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $10.96 Typical High $34.67 | Professional | None | $7.76 | $10.96 | $34.67 |
Molina Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Providence Setting Facility Modifier None Typical Low $12.30 Median $23.44 Typical High $39.81 | Facility | None | $12.30 | $23.44 | $39.81 |
Providence Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $48.98 | Professional | None | $12.30 | $12.30 | $48.98 |
Sutter Health Plus Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $3.09 Median $7.76 Typical High $18.20 | Professional | None | $3.09 | $7.76 | $18.20 |
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 $4.07 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $4.07 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $2.45 Typical High $2.51 | Professional | 53 · Discontinued | $1.62 | $2.45 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.23 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $0.81 | $1.23 | $1.23 |
Where California sits
The same service costs 6.3 times more in Wyoming than in Rhode Island. 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· 20th of 51
$12.30
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.