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 $0.31 Median $0.31 Typical High $0.58 | Facility | None | $0.31 | $0.31 | $0.58 |
Aetna Setting Professional Modifier None Typical Low $0.30 Median $0.33 Typical High $0.46 | Professional | None | $0.30 | $0.33 | $0.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.34 Median $0.54 Typical High $1.12 | Facility | None | $0.34 | $0.54 | $1.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.32 Median $0.40 Typical High $1.45 | Professional | None | $0.32 | $0.40 | $1.45 |
Blue Shield Setting Facility Modifier None Typical Low $0.44 Median $0.54 Typical High $0.98 | Facility | None | $0.44 | $0.54 | $0.98 |
Blue Shield Setting Professional Modifier None Typical Low $0.31 Median $0.37 Typical High $0.93 | Professional | None | $0.31 | $0.37 | $0.93 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $0.28 Median $0.34 Typical High $0.47 | Professional | None | $0.28 | $0.34 | $0.47 |
Cigna Setting Facility Modifier None Typical Low $0.31 Median $0.48 Typical High $0.78 | Facility | None | $0.31 | $0.48 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $0.41 | Professional | None | $0.41 | $0.41 | $0.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $0.28 Median $0.38 Typical High $0.87 | Professional | None | $0.28 | $0.38 | $0.87 |
Providence Setting Facility Modifier None Typical Low $0.31 Median $0.48 Typical High $0.83 | Facility | None | $0.31 | $0.48 | $0.83 |
Providence Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | None | $0.31 | $0.31 | $0.31 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.34 Typical High $1.32 | Professional | None | $0.32 | $0.34 | $1.32 |
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 $0.16 Median $0.16 Typical High $0.16 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where California sits
The same service costs 3.3 times more in Texas than in North Dakota. 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· 10th of 51
$0.40
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.