How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $30.20 Median $4,897.79 Typical High $4,897.79 | Facility | None | $30.20 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $4,897.79 | Professional | None | $30.20 | $30.20 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $239.88 | Professional | None | $64.57 | $162.18 | $239.88 |
Blue Shield Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $63.10 | Professional | None | $38.02 | $54.95 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $426.58 | Professional | None | $112.20 | $204.17 | $426.58 |
Lucent Health Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $537.03 | Professional | None | $371.54 | $537.03 | $537.03 |
Molina Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $25.12 | Professional | None | $17.38 | $17.38 | $25.12 |
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 $30.20 Median $42.66 Typical High $7,079.46 | Facility | None | $30.20 | $42.66 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
United Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $74.13 | Professional | None | $60.26 | $61.66 | $74.13 |
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 $15.14 Median $15.14 Typical High $2,454.71 | Professional | 52 · Reduced service | $15.14 | $15.14 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $977.24 | Professional | 53 · Discontinued | $6.03 | $6.03 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $741.31 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $489.78 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $489.78 |
Where California sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 23rd 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.