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 $0.35 Median $0.35 Typical High $0.63 | Facility | None | $0.35 | $0.35 | $0.63 |
Aetna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.36 Median $0.42 Typical High $0.52 | Facility | None | $0.36 | $0.42 | $0.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.45 | Professional | None | $0.36 | $0.36 | $0.45 |
Blue Shield Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $0.36 Median $0.72 Typical High $1.10 | Facility | None | $0.36 | $0.72 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $630.96 Typical High $831.76 | Professional | None | $128.82 | $630.96 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Providence Setting Facility Modifier None Typical Low $0.36 Median $0.50 Typical High $0.98 | Facility | None | $0.36 | $0.50 | $0.98 |
Providence Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.42 | Professional | None | $0.35 | $0.35 | $0.42 |
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 $0.18 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where California sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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
$0.36
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.