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 $52.48 Median $53.70 Typical High $77.62 | Facility | None | $52.48 | $53.70 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | None | $52.48 | $53.70 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $89.13 Typical High $190.55 | Facility | None | $61.66 | $89.13 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $144.54 | Professional | None | $52.48 | $70.79 | $144.54 |
Blue Shield Setting Facility Modifier None Typical Low $52.48 Median $117.49 Typical High $177.83 | Facility | None | $52.48 | $117.49 | $177.83 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $208.93 | Professional | None | $72.44 | $109.65 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $79.43 | Professional | None | $47.86 | $52.48 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $95.50 Typical High $144.54 | Facility | None | $47.86 | $95.50 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $141.25 | Professional | None | $47.86 | $63.10 | $141.25 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Providence Setting Facility Modifier None Typical Low $47.86 Median $85.11 Typical High $147.91 | Facility | None | $47.86 | $85.11 | $147.91 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $102.33 | Professional | None | $47.86 | $47.86 | $102.33 |
Sutter Health Plus Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $177.83 | Facility | None | $52.48 | $52.48 | $177.83 |
United Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $141.25 | Professional | None | $52.48 | $52.48 | $141.25 |
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 $26.30 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.30 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where California sits
The same service costs 1.7 times more in Arizona 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· 4th of 51
$77.62
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.