How much rates vary
Facilitymedian $15 · 10th to 90th $7 to $74Professionalmedian $6 · 10th to 90th $4 to $16
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 $8.13 Median $19.50 Typical High $50.12 | Facility | None | $8.13 | $19.50 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $10.23 | Professional | None | $7.08 | $8.32 | $10.23 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $3.72 Typical High $4.90 | Professional | None | $2.34 | $3.72 | $4.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $13.18 Typical High $34.67 | Facility | None | $8.71 | $13.18 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $5.25 Typical High $15.85 | Professional | None | $4.27 | $5.25 | $15.85 |
Blue Shield Setting Facility Modifier None Typical Low $18.20 Median $61.66 Typical High $107.15 | Facility | None | $18.20 | $61.66 | $107.15 |
Blue Shield Setting Professional Modifier None Typical Low $4.37 Median $6.17 Typical High $9.33 | Professional | None | $4.37 | $6.17 | $9.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $9.12 | Professional | None | $5.62 | $5.62 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $10.72 Typical High $23.99 | Facility | None | $4.90 | $10.72 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $7.59 Typical High $23.44 | Professional | None | $4.57 | $7.59 | $23.44 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.17 Median $7.76 Typical High $7.76 | Professional | None | $6.17 | $7.76 | $7.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.03 Median $7.76 Typical High $18.62 | Professional | None | $6.03 | $7.76 | $18.62 |
Molina Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $8.32 | Professional | None | $4.17 | $4.17 | $8.32 |
Providence Setting Facility Modifier None Typical Low $5.62 Median $8.91 Typical High $20.89 | Facility | None | $5.62 | $8.91 | $20.89 |
Providence Setting Professional Modifier None Typical Low $4.68 Median $7.08 Typical High $17.38 | Professional | None | $4.68 | $7.08 | $17.38 |
Sutter Health Plus Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
United Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $7.08 | Facility | None | $2.95 | $2.95 | $7.08 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.17 Typical High $18.62 | Professional | None | $2.95 | $4.17 | $18.62 |
7 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 Facility Modifier 52 · Reduced service Typical Low $4.07 Median $10.72 Typical High $25.70 | Facility | 52 · Reduced service | $4.07 | $10.72 | $25.70 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.62 Median $4.27 Typical High $10.23 | Facility | 53 · Discontinued | $1.62 | $4.27 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.82 Median $4.17 Typical High $4.17 | Professional | 52 · Reduced service | $2.82 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.12 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $4.79 Median $9.33 Typical High $10.23 | Professional | QW · Waived lab test | $4.79 | $9.33 | $10.23 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $5.62 Median $8.32 Typical High $19.50 | Professional | QW · Waived lab test | $5.62 | $8.32 | $19.50 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | QW · Waived lab test | $24.55 | $24.55 | $24.55 |
Where California sits
The same service costs 9.3 times more in Vermont than in New Jersey. 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· 23rd of 51
$7.76
VT $45.71NJ $4.90
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.