How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $2Professionalmedian $1 · 10th to 90th $1 to $1
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 $1.02 Median $1.41 Typical High $2.34 | Facility | None | $1.02 | $1.41 | $2.34 |
Aetna Setting Professional Modifier None Typical Low $1.02 Median $1.07 Typical High $1.51 | Professional | None | $1.02 | $1.07 | $1.51 |
Ambetter Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.93 Median $1.12 Typical High $1.51 | Facility | None | $0.93 | $1.12 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.93 Median $0.93 Typical High $1.35 | Professional | None | $0.93 | $0.93 | $1.35 |
Blue Shield Setting Facility Modifier None Typical Low $0.98 Median $1.05 Typical High $1.45 | Facility | None | $0.98 | $1.05 | $1.45 |
Blue Shield Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.26 | Professional | None | $1.02 | $1.02 | $1.26 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.02 Median $1.12 Typical High $1.12 | Professional | None | $1.02 | $1.12 | $1.12 |
Cigna Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $1.32 | Professional | None | $1.07 | $1.07 | $1.32 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.93 Median $1.05 Typical High $1.26 | Professional | None | $0.93 | $1.05 | $1.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.85 Median $0.91 Typical High $1.70 | Professional | None | $0.85 | $0.91 | $1.70 |
Lucent Health Setting Professional Modifier None Typical Low $1.02 Median $1.51 Typical High $1.91 | Professional | None | $1.02 | $1.51 | $1.91 |
Molina Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $0.98 | Professional | None | $0.98 | $0.98 | $0.98 |
Providence Setting Facility Modifier None Typical Low $0.89 Median $1.15 Typical High $1.86 | Facility | None | $0.89 | $1.15 | $1.86 |
Providence Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $1.86 | Professional | None | $1.12 | $1.23 | $1.86 |
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 $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $0.89 Median $0.95 Typical High $1.26 | Professional | None | $0.89 | $0.95 | $1.26 |
8 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 Facility Modifier 52 · Reduced service Typical Low $0.51 Median $0.71 Typical High $1.20 | Facility | 52 · Reduced service | $0.51 | $0.71 | $1.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.20 Median $0.28 Typical High $0.47 | Facility | 53 · Discontinued | $0.20 | $0.28 | $0.47 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.15 Median $0.21 Typical High $0.36 | Facility | 55 · Aftercare only | $0.15 | $0.21 | $0.36 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.14 Typical High $0.24 | Facility | 56 · Pre-op care only | $0.10 | $0.14 | $0.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.51 Median $0.52 Typical High $0.52 | Professional | 52 · Reduced service | $0.51 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.20 Median $0.21 Typical High $0.21 | Professional | 53 · Discontinued | $0.20 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Where California sits
The same service costs 1.5 times more in Alaska than in New Mexico. 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
$1.02
AK $1.35NM $0.89
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.