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 $67.61 Median $67.61 Typical High $144.54 | Facility | None | $67.61 | $67.61 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $100.00 | Professional | None | $67.61 | $74.13 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $128.82 Typical High $275.42 | Facility | None | $83.18 | $128.82 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $371.54 | Professional | None | $79.43 | $79.43 | $371.54 |
Blue Shield Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $208.93 | Facility | None | $74.13 | $95.50 | $208.93 |
Blue Shield Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $288.40 | Professional | None | $72.44 | $89.13 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $100.00 | Professional | None | $60.26 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $165.96 | Facility | None | $67.61 | $112.20 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Contra Costa Health Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $186.21 | Professional | None | $60.26 | $91.20 | $186.21 |
Molina Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $186.21 | Facility | None | $67.61 | $112.20 | $186.21 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Sutter Health Plus Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $85.11 Typical High $269.15 | Professional | None | $79.43 | $85.11 | $269.15 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.00 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where California sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 20th of 51
$87.10
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.