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 $0.02 Median $0.05 Typical High $0.07 | Facility | None | $0.02 | $0.05 | $0.07 |
Aetna Setting Professional Modifier None (both parts) Typical Low $0.02 Median $0.04 Typical High $0.07 | Professional | None (both parts) | $0.02 | $0.04 | $0.07 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None (both parts) | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $4.17 Typical High $4.57 | Facility | None | $3.89 | $4.17 | $4.57 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $3.89 Median $3.89 Typical High $45.71 | Professional | None (both parts) | $3.89 | $3.89 | $45.71 |
Blue Shield Setting Professional Modifier None (both parts) Typical Low $26.92 Median $38.02 Typical High $52.48 | Professional | None (both parts) | $26.92 | $38.02 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,165.95 | Facility | None | $5,623.41 | $5,623.41 | $6,165.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $28.18 Median $28.18 Typical High $35.48 | Professional | None (both parts) | $28.18 | $28.18 | $35.48 |
Contra Costa Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.96 Median $33.11 Typical High $407.38 | Professional | None | $10.96 | $33.11 | $407.38 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None (both parts) | $10.23 | $10.23 | $10.23 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $23.99 Typical High $6,165.95 | Facility | None | $13.49 | $23.99 | $6,165.95 |
Providence Setting Professional Modifier None (both parts) Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None (both parts) | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None (both parts) Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None (both parts) | $22.91 | $22.91 | $22.91 |
3 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 $0.02 Median $0.03 Typical High $0.04 | Facility | 52 · Reduced service | $0.02 | $0.03 | $0.04 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 26 · Professional part | $5.01 | $5.01 | $5.01 |
Where California sits
The same service costs 6166.0 times more in Kansas than in Tennessee. 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· 12th of 51
$29.51
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.