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 $3.31 Median $4.27 Typical High $8.71 | Facility | None | $3.31 | $4.27 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $8.71 | Professional | None | $3.31 | $4.27 | $8.71 |
Ambetter Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $7.08 | Professional | None | $3.02 | $3.02 | $7.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $6.46 Typical High $16.98 | Facility | None | $3.89 | $6.46 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.51 Median $3.63 Typical High $6.03 | Professional | None | $1.51 | $3.63 | $6.03 |
CareSource Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
CareSource Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $4.90 | Professional | None | $3.24 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $10.96 Typical High $26.30 | Facility | None | $4.90 | $10.96 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.63 Typical High $7.76 | Professional | None | $3.09 | $3.63 | $7.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.50 Median $7.41 Typical High $10.72 | Professional | None | $5.50 | $7.41 | $10.72 |
United Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $10.47 | Facility | None | $1.38 | $1.38 | $10.47 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.95 Typical High $10.47 | Professional | None | $1.95 | $2.95 | $10.47 |
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 Professional Modifier 52 · Reduced service Typical Low $1.66 Median $2.09 Typical High $2.40 | Professional | 52 · Reduced service | $1.66 | $2.09 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.66 Median $0.83 Typical High $0.95 | Professional | 53 · Discontinued | $0.66 | $0.83 | $0.95 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.24 Median $2.24 Typical High $4.90 | Professional | QW · Waived lab test | $2.24 | $2.24 | $4.90 |
Where Georgia sits
The same service costs 9.3 times more in Vermont 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.
Georgia· 51st of 51
$3.63
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.