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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $33.11 Typical High $138.04 | Facility | None | $26.30 | $33.11 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $66.07 | Professional | None | $26.92 | $26.92 | $66.07 |
Blue Shield Setting Facility Modifier None Typical Low $27.54 Median $35.48 Typical High $66.07 | Facility | None | $27.54 | $35.48 | $66.07 |
Blue Shield Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $70.79 | Professional | None | $26.92 | $31.62 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $64.57 Typical High $100.00 | Facility | None | $32.36 | $64.57 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Contra Costa Health Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.92 Median $38.90 Typical High $64.57 | Professional | None | $26.92 | $38.90 | $64.57 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $45.71 Typical High $87.10 | Facility | None | $31.62 | $45.71 | $87.10 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $79.43 | Professional | None | $32.36 | $32.36 | $79.43 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
Where California sits
The same service costs 1.9 times more in Alaska than in Connecticut. 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· 27th of 51
$32.36
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.