How much rates vary
Facilitymedian $9 · 10th to 90th $2 to $46Professionalmedian $5 · 10th to 90th $3 to $12
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 $5.50 Median $11.48 Typical High $36.31 | Facility | None | $5.50 | $11.48 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $6.03 Typical High $8.13 | Professional | None | $5.01 | $6.03 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $2.29 Median $2.51 Typical High $6.03 | Professional | None | $2.29 | $2.51 | $6.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.17 Median $9.55 Typical High $24.55 | Facility | None | $6.17 | $9.55 | $24.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.72 Typical High $11.22 | Professional | None | $3.09 | $3.72 | $11.22 |
Blue Shield Setting Facility Modifier None Typical Low $12.88 Median $45.71 Typical High $75.86 | Facility | None | $12.88 | $45.71 | $75.86 |
Blue Shield Setting Professional Modifier None Typical Low $3.09 Median $4.47 Typical High $7.94 | Professional | None | $3.09 | $4.47 | $7.94 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $6.46 | Professional | None | $3.98 | $3.98 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $7.59 Typical High $17.38 | Facility | None | $3.55 | $7.59 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $3.16 Median $5.62 Typical High $16.98 | Professional | None | $3.16 | $5.62 | $16.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $5.50 | Professional | None | $4.37 | $5.50 | $5.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $13.49 | Professional | None | $4.27 | $5.01 | $13.49 |
Lucent Health Setting Professional Modifier None Typical Low $4.27 Median $6.31 Typical High $10.23 | Professional | None | $4.27 | $6.31 | $10.23 |
Molina Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $6.03 | Professional | None | $3.02 | $3.02 | $6.03 |
Providence Setting Facility Modifier None Typical Low $4.17 Median $6.31 Typical High $14.79 | Facility | None | $4.17 | $6.31 | $14.79 |
Providence Setting Professional Modifier None Typical Low $3.16 Median $5.01 Typical High $12.30 | Professional | None | $3.16 | $5.01 | $12.30 |
Sutter Health Plus Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
United Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | None | $1.58 | $1.58 | $1.58 |
United Setting Professional Modifier None Typical Low $2.09 Median $3.02 Typical High $13.49 | Professional | None | $2.09 | $3.02 | $13.49 |
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 $2.95 Median $7.59 Typical High $18.20 | Facility | 52 · Reduced service | $2.95 | $7.59 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.17 Median $3.02 Typical High $7.24 | Facility | 53 · Discontinued | $1.17 | $3.02 | $7.24 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $3.02 Typical High $3.02 | Professional | 52 · Reduced service | $2.14 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.20 Typical High $1.20 | Professional | 53 · Discontinued | $0.85 | $1.20 | $1.20 |
Where California sits
The same service costs 8.9 times more in Vermont than in Maryland. 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· 26th of 51
$5.50
VT $33.88MD $3.80
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.