How much rates vary
Facilitymedian $3 · 10th to 90th $1 to $6Professionalmedian $1 · 10th to 90th $1 to $2
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 $1.32 Median $1.86 Typical High $3.39 | Facility | None | $1.32 | $1.86 | $3.39 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.82 | Professional | None | $1.32 | $1.32 | $1.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.38 Median $1.58 Typical High $1.95 | Facility | None | $1.38 | $1.58 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.04 | Professional | None | $1.38 | $1.38 | $2.04 |
Blue Shield Setting Facility Modifier None Typical Low $1.86 Median $5.13 Typical High $6.61 | Facility | None | $1.86 | $5.13 | $6.61 |
Blue Shield Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.58 | Professional | None | $1.32 | $1.32 | $1.58 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.32 Median $1.45 Typical High $1.45 | Professional | None | $1.32 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $2.40 Typical High $3.24 | Facility | None | $1.29 | $2.40 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.70 Median $1.86 Typical High $2.04 | Professional | None | $1.70 | $1.86 | $2.04 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.20 Median $1.32 Typical High $2.34 | Professional | None | $1.20 | $1.32 | $2.34 |
Lucent Health Setting Professional Modifier None Typical Low $1.51 Median $2.24 Typical High $5.13 | Professional | None | $1.51 | $2.24 | $5.13 |
Molina Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Professional | None | $1.58 | $1.58 | $1.58 |
Providence Setting Facility Modifier None Typical Low $1.32 Median $2.45 Typical High $4.17 | Facility | None | $1.32 | $2.45 | $4.17 |
Providence Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Sutter Health Plus Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
United Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.41 Typical High $1.62 | Professional | None | $1.32 | $1.41 | $1.62 |
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 $0.66 Median $1.05 Typical High $1.78 | Facility | 52 · Reduced service | $0.66 | $1.05 | $1.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.26 Median $0.41 Typical High $0.71 | Facility | 53 · Discontinued | $0.26 | $0.41 | $0.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.31 Typical High $0.52 | Facility | 55 · Aftercare only | $0.20 | $0.31 | $0.52 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.21 Typical High $0.35 | Facility | 56 · Pre-op care only | $0.13 | $0.21 | $0.35 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 52 · Reduced service | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where California sits
The same service costs 1.9 times more in Wyoming than in Florida. 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· 44th of 51
$1.32
WY $2.45FL $1.32
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.