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 $3.02 Median $3.63 Typical High $3.63 | Facility | None | $3.02 | $3.63 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $1.51 Median $3.63 Typical High $8.51 | Professional | None | $1.51 | $3.63 | $8.51 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.72 Median $4.68 Typical High $19.05 | Facility | None | $3.72 | $4.68 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $9.55 | Professional | None | $3.72 | $3.98 | $9.55 |
Blue Shield Setting Professional Modifier None Typical Low $4.17 Median $6.03 Typical High $8.71 | Professional | None | $4.17 | $6.03 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $1.58 Median $1.70 Typical High $3.09 | Facility | None | $1.58 | $1.70 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $6.46 Typical High $6.46 | Professional | None | $3.72 | $6.46 | $6.46 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
HealthNet Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.00 Median $12.88 Typical High $32.36 | Professional | None | $10.00 | $12.88 | $32.36 |
Providence Setting Facility Modifier None Typical Low $4.37 Median $8.71 Typical High $15.14 | Facility | None | $4.37 | $8.71 | $15.14 |
Providence Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $12.59 | Professional | None | $6.46 | $6.46 | $12.59 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.72 Typical High $34.67 | Professional | None | $7.76 | $10.72 | $34.67 |
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 $1.51 Median $1.78 Typical High $3.72 | Professional | 52 · Reduced service | $1.51 | $1.78 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.71 Typical High $1.48 | Professional | 53 · Discontinued | $0.62 | $0.71 | $1.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.52 Typical High $1.12 | Professional | 55 · Aftercare only | $0.46 | $0.52 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.35 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.30 | $0.35 | $0.76 |
Where California sits
The same service costs 25.1 times more in Wyoming than in New Jersey. 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· 45th of 51
$6.03
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.