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 $2.29 Median $6.61 Typical High $15.85 | Facility | None | $2.29 | $6.61 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $2.14 Median $2.57 Typical High $3.55 | Professional | None | $2.14 | $2.57 | $3.55 |
Ambetter Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $11.22 | Professional | None | $1.10 | $1.10 | $11.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.69 Median $4.07 Typical High $10.72 | Facility | None | $2.69 | $4.07 | $10.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.07 Median $1.55 Typical High $5.25 | Professional | None | $1.07 | $1.55 | $5.25 |
Blue Shield Setting Facility Modifier None Typical Low $5.75 Median $20.42 Typical High $38.90 | Facility | None | $5.75 | $20.42 | $38.90 |
Blue Shield Setting Professional Modifier None Typical Low $1.35 Median $1.91 Typical High $3.47 | Professional | None | $1.35 | $1.91 | $3.47 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.82 | Professional | None | $1.74 | $1.74 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $3.31 Typical High $7.41 | Facility | None | $1.51 | $3.31 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $2.34 Typical High $7.24 | Professional | None | $1.41 | $2.34 | $7.24 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.78 Median $2.40 Typical High $2.40 | Professional | None | $1.78 | $2.40 | $2.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.82 Median $2.40 Typical High $6.03 | Professional | None | $1.82 | $2.40 | $6.03 |
Molina Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Providence Setting Facility Modifier None Typical Low $1.82 Median $2.82 Typical High $7.24 | Facility | None | $1.82 | $2.82 | $7.24 |
Providence Setting Professional Modifier None Typical Low $1.41 Median $2.19 Typical High $5.25 | Professional | None | $1.41 | $2.19 | $5.25 |
Sutter Health Plus Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
United Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.86 Typical High $5.75 | Professional | None | $1.29 | $1.86 | $5.75 |
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 Facility Modifier 52 · Reduced service Typical Low $1.26 Median $3.31 Typical High $7.94 | Facility | 52 · Reduced service | $1.26 | $3.31 | $7.94 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.51 Median $1.32 Typical High $3.16 | Facility | 53 · Discontinued | $0.51 | $1.32 | $3.16 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.91 Median $1.29 Typical High $1.29 | Professional | 52 · Reduced service | $0.91 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.52 Typical High $0.52 | Professional | 53 · Discontinued | $0.37 | $0.52 | $0.52 |
Where California sits
The same service costs 3.2 times more in Kansas than in Washington, DC. 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· 18th of 51
$2.57
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.