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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $33.88 Median $42.66 Typical High $173.78 | Facility | None | $33.88 | $42.66 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $83.18 | Professional | None | $33.88 | $33.88 | $83.18 |
Blue Shield Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $85.11 | Facility | None | $33.88 | $33.88 | $85.11 |
Blue Shield Setting Professional Modifier None Typical Low $20.89 Median $29.51 Typical High $37.15 | Professional | None | $20.89 | $29.51 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $190.55 Typical High $302.00 | Facility | None | $141.25 | $190.55 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Contra Costa Health Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $239.88 | Professional | None | $177.83 | $199.53 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $331.13 | Professional | None | $134.90 | $165.96 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $295.12 | Facility | None | $125.89 | $186.21 | $295.12 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 53 · Discontinued | $6.76 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.47 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.39 | $3.47 | $3.47 |
Where California sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 35th of 51
$45.71
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.