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 $52.48 Typical High $95.50 | Facility | None | $52.48 | $52.48 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $77.62 | Facility | None | $54.95 | $63.10 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $128.82 | Professional | None | $53.70 | $57.54 | $128.82 |
Blue Shield Setting Facility Modifier None Typical Low $93.33 Median $147.91 Typical High $380.19 | Facility | None | $93.33 | $147.91 | $380.19 |
Blue Shield Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $75.86 | Professional | None | $22.91 | $34.67 | $75.86 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $79.43 | Professional | None | $52.48 | $52.48 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $107.15 Typical High $162.18 | Facility | None | $53.70 | $107.15 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Providence Setting Facility Modifier None Typical Low $52.48 Median $75.86 Typical High $144.54 | Facility | None | $52.48 | $75.86 | $144.54 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $67.61 | Professional | None | $53.70 | $53.70 | $67.61 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $87.10 | Facility | None | $56.23 | $56.23 | $87.10 |
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 $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $10.47 | $10.47 | $10.47 |
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 $5.25 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $5.25 |
Where California sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 9th of 51
$53.70
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.