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 $60.26 Median $60.26 Typical High $109.65 | Facility | None | $60.26 | $60.26 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $70.79 Typical High $89.13 | Facility | None | $61.66 | $70.79 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $93.33 | Professional | None | $61.66 | $61.66 | $93.33 |
Blue Shield Setting Facility Modifier None Typical Low $60.26 Median $64.57 Typical High $91.20 | Facility | None | $60.26 | $64.57 | $91.20 |
Blue Shield Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $74.13 | Professional | None | $60.26 | $60.26 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $123.03 Typical High $186.21 | Facility | None | $61.66 | $123.03 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $102.33 Typical High $165.96 | Facility | None | $61.66 | $102.33 | $165.96 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $102.33 | Professional | None | $60.26 | $60.26 | $102.33 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
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· 29th of 51
$61.66
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.