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 $1.86 Median $1.91 Typical High $3.02 | Facility | None | $1.86 | $1.91 | $3.02 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.91 Typical High $1.91 | Professional | None | $1.86 | $1.91 | $1.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.62 Median $2.04 Typical High $2.75 | Facility | None | $1.62 | $2.04 | $2.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $2.69 | Professional | None | $1.66 | $1.66 | $2.69 |
Blue Shield Setting Facility Modifier None Typical Low $2.00 Median $2.09 Typical High $2.82 | Facility | None | $2.00 | $2.09 | $2.82 |
Blue Shield Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.29 | Professional | None | $1.86 | $1.86 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $1.95 Median $3.39 Typical High $4.68 | Facility | None | $1.95 | $3.39 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $1.78 | Professional | None | $1.35 | $1.48 | $1.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.55 Median $1.70 Typical High $2.88 | Professional | None | $1.55 | $1.70 | $2.88 |
Lucent Health Setting Professional Modifier None Typical Low $0.95 Median $1.95 Typical High $2.45 | Professional | None | $0.95 | $1.95 | $2.45 |
Molina Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Providence Setting Facility Modifier None Typical Low $1.86 Median $3.55 Typical High $6.03 | Facility | None | $1.86 | $3.55 | $6.03 |
Providence Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | None | $1.86 | $1.86 | $1.86 |
Sutter Health Plus Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
United Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
United Setting Professional Modifier None Typical Low $0.81 Median $1.66 Typical High $2.34 | Professional | None | $0.81 | $1.66 | $2.34 |
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 $0.93 Median $0.95 Typical High $0.95 | Professional | 52 · Reduced service | $0.93 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.38 Typical High $0.38 | Professional | 53 · Discontinued | $0.37 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.19 |
Where California sits
Rates are fairly even across states for this service. 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· 12th of 51
$1.86
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.