How much rates vary
Facilitymedian $30 · 10th to 90th $5 to $95Professionalmedian $12 · 10th to 90th $7 to $35
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 $15.85 Median $33.11 Typical High $97.72 | Facility | None | $15.85 | $33.11 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $19.05 | Professional | None | $12.30 | $16.22 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $21.88 | Professional | None | $6.92 | $9.12 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $24.55 Typical High $67.61 | Facility | None | $16.98 | $24.55 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $9.33 Typical High $30.90 | Professional | None | $6.76 | $9.33 | $30.90 |
Blue Shield Setting Facility Modifier None Typical Low $35.48 Median $109.65 Typical High $208.93 | Facility | None | $35.48 | $109.65 | $208.93 |
Blue Shield Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $18.20 | Professional | None | $8.51 | $12.02 | $18.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $17.78 | Professional | None | $10.96 | $10.96 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $20.89 Typical High $45.71 | Facility | None | $9.55 | $20.89 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $14.45 Typical High $44.67 | Professional | None | $8.91 | $14.45 | $44.67 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $15.14 | Professional | None | $12.02 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.75 Median $15.14 Typical High $38.02 | Professional | None | $11.75 | $15.14 | $38.02 |
Lucent Health Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $81.28 | Professional | None | $18.62 | $26.30 | $81.28 |
Molina Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $16.60 | Professional | None | $8.13 | $8.13 | $16.60 |
Providence Setting Facility Modifier None Typical Low $11.22 Median $17.38 Typical High $42.66 | Facility | None | $11.22 | $17.38 | $42.66 |
Providence Setting Professional Modifier None Typical Low $8.91 Median $13.80 Typical High $34.67 | Professional | None | $8.91 | $13.80 | $34.67 |
Sutter Health Plus Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.75 Typical High $36.31 | Facility | None | $4.79 | $5.75 | $36.31 |
United Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $36.31 | Professional | None | $5.75 | $8.13 | $36.31 |
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 $7.94 Median $20.89 Typical High $50.12 | Facility | 52 · Reduced service | $7.94 | $20.89 | $50.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.16 Median $8.32 Typical High $19.95 | Facility | 53 · Discontinued | $3.16 | $8.32 | $19.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $5.50 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $2.24 | $3.24 | $3.24 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $9.33 Median $17.78 Typical High $19.95 | Professional | QW · Waived lab test | $9.33 | $17.78 | $19.95 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $10.96 Median $16.60 Typical High $38.02 | Professional | QW · Waived lab test | $10.96 | $16.60 | $38.02 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | QW · Waived lab test | $47.86 | $47.86 | $47.86 |
Where California sits
The same service costs 9.5 times more in Vermont than in Rhode Island. 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
$14.79
VT $97.72RI $10.23
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.