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 $20.89 Median $20.89 Typical High $24.55 | Facility | None | $20.89 | $20.89 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $24.55 | Professional | None | $17.78 | $20.89 | $24.55 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | None | $19.95 | $19.95 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.46 Median $0.58 Typical High $2.34 | Facility | None | $0.46 | $0.58 | $2.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $37.15 Typical High $117.49 | Professional | None | $15.85 | $37.15 | $117.49 |
Blue Shield Setting Facility Modifier None Typical Low $42.66 Median $102.33 Typical High $158.49 | Facility | None | $42.66 | $102.33 | $158.49 |
Blue Shield Setting Professional Modifier None Typical Low $14.45 Median $20.89 Typical High $35.48 | Professional | None | $14.45 | $20.89 | $35.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $21.38 Median $40.74 Typical High $40.74 | Professional | None | $21.38 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $14.13 Median $36.31 Typical High $48.98 | Professional | None | $14.13 | $36.31 | $48.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $66.07 | Professional | None | $26.92 | $32.36 | $66.07 |
Lucent Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | None | $147.91 | $147.91 | $223.87 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | None | $27.54 | $27.54 | $33.11 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $30.20 Typical High $50.12 | Facility | None | $20.42 | $30.20 | $50.12 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $46.77 | Professional | None | $23.99 | $23.99 | $46.77 |
Sutter Health Plus Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $16.60 Median $23.99 Typical High $58.88 | Professional | None | $16.60 | $23.99 | $58.88 |
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 $8.91 Median $10.47 Typical High $12.30 | Professional | 52 · Reduced service | $8.91 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.17 Typical High $4.90 | Professional | 53 · Discontinued | $3.55 | $4.17 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.16 Typical High $3.63 | Professional | 55 · Aftercare only | $2.63 | $3.16 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.09 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.78 | $2.09 | $2.45 |
Where California sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 31st of 51
$24.55
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.