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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.00 Median $12.59 Typical High $52.48 | Facility | None | $10.00 | $12.59 | $52.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $31.62 | Professional | None | $10.00 | $10.00 | $31.62 |
Blue Shield Setting Facility Modifier None Typical Low $11.75 Median $13.18 Typical High $25.12 | Facility | None | $11.75 | $13.18 | $25.12 |
Blue Shield Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $13.18 | Professional | None | $10.00 | $10.00 | $13.18 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | None | $11.75 | $11.75 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $66.07 Typical High $100.00 | Facility | None | $33.11 | $66.07 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.00 Median $11.22 Typical High $13.49 | Professional | None | $10.00 | $11.22 | $13.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $14.13 Median $25.12 Typical High $630.96 | Professional | None | $14.13 | $25.12 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Molina Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
Providence Setting Facility Modifier None Typical Low $10.00 Median $46.77 Typical High $89.13 | Facility | None | $10.00 | $46.77 | $89.13 |
Providence Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $14.13 Median $38.90 Typical High $46.77 | Professional | None | $14.13 | $38.90 | $46.77 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where California sits
The same service costs 5.6 times more in Alaska 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· 38th 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.