How much rates vary
Facilitymedian $12 · 10th to 90th $5 to $48Professionalmedian $5 · 10th to 90th $3 to $11
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 $6.03 Median $14.13 Typical High $38.02 | Facility | None | $6.03 | $14.13 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $6.17 Typical High $7.41 | Professional | None | $5.13 | $6.17 | $7.41 |
Ambetter Setting Professional Modifier None Typical Low $1.74 Median $3.16 Typical High $4.68 | Professional | None | $1.74 | $3.16 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.31 Median $9.33 Typical High $25.70 | Facility | None | $6.31 | $9.33 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $3.55 Typical High $11.48 | Professional | None | $2.51 | $3.55 | $11.48 |
Blue Shield Setting Facility Modifier None Typical Low $13.18 Median $45.71 Typical High $77.62 | Facility | None | $13.18 | $45.71 | $77.62 |
Blue Shield Setting Professional Modifier None Typical Low $3.24 Median $4.57 Typical High $8.32 | Professional | None | $3.24 | $4.57 | $8.32 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $6.76 | Professional | None | $4.17 | $4.17 | $6.76 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $7.76 Typical High $17.78 | Facility | None | $3.63 | $7.76 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $5.62 Typical High $16.98 | Professional | None | $3.39 | $5.62 | $16.98 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.07 Median $5.62 Typical High $5.62 | Professional | None | $4.07 | $5.62 | $5.62 |
HealthNet Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.47 Median $5.13 Typical High $13.80 | Professional | None | $4.47 | $5.13 | $13.80 |
Lucent Health Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $7.76 | Professional | None | $4.37 | $5.50 | $7.76 |
Molina Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $6.17 | Professional | None | $3.09 | $3.09 | $6.17 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $6.46 Typical High $15.49 | Facility | None | $4.27 | $6.46 | $15.49 |
Providence Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $12.88 | Professional | None | $3.39 | $5.13 | $12.88 |
Sutter Health Plus Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
United Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $2.19 Median $3.09 Typical High $13.80 | Professional | None | $2.19 | $3.09 | $13.80 |
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 $3.02 Median $7.76 Typical High $18.62 | Facility | 52 · Reduced service | $3.02 | $7.76 | $18.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.20 Median $3.16 Typical High $7.59 | Facility | 53 · Discontinued | $1.20 | $3.16 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.19 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $0.87 | $1.23 | $1.23 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $3.55 Median $6.76 Typical High $7.41 | Professional | QW · Waived lab test | $3.55 | $6.76 | $7.41 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $4.37 Median $6.17 Typical High $14.45 | Professional | QW · Waived lab test | $4.37 | $6.17 | $14.45 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | QW · Waived lab test | $18.20 | $18.20 | $18.20 |
Where California sits
The same service costs 8.1 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· 21st of 51
$6.03
VT $31.62MD $3.89
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.