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 $26.92 Median $26.92 Typical High $48.98 | Facility | None | $26.92 | $26.92 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $28.84 Typical High $37.15 | Professional | None | $26.92 | $28.84 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $44.67 Typical High $95.50 | Facility | None | $28.84 | $44.67 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $123.03 | Professional | None | $26.92 | $36.31 | $123.03 |
Blue Shield Setting Facility Modifier None Typical Low $38.02 Median $77.62 Typical High $100.00 | Facility | None | $38.02 | $77.62 | $100.00 |
Blue Shield Setting Professional Modifier None Typical Low $26.92 Median $32.36 Typical High $85.11 | Professional | None | $26.92 | $32.36 | $85.11 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $23.99 Median $29.51 Typical High $39.81 | Professional | None | $23.99 | $29.51 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $46.77 Typical High $66.07 | Facility | None | $26.92 | $46.77 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $23.99 Median $32.36 Typical High $74.13 | Professional | None | $23.99 | $32.36 | $74.13 |
Providence Setting Facility Modifier None Typical Low $26.92 Median $48.98 Typical High $74.13 | Facility | None | $26.92 | $48.98 | $74.13 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $57.54 | Professional | None | $26.92 | $26.92 | $57.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $169.82 | Facility | None | $26.92 | $26.92 | $169.82 |
United Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $74.13 | Professional | None | $26.92 | $26.92 | $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 $13.18 Median $13.49 Typical High $13.49 | Professional | 52 · Reduced service | $13.18 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 53 · Discontinued | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.98 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.69 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.63 | $2.69 | $2.69 |
Where California sits
The same service costs 2.9 times more in Wyoming than in Minnesota. 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· 8th of 51
$34.67
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.