How much rates vary
Facilitymedian $10 · 10th to 90th $4 to $37Professionalmedian $4 · 10th to 90th $2 to $10
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 $4.57 Median $9.55 Typical High $31.62 | Facility | None | $4.57 | $9.55 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $4.68 Typical High $7.59 | Professional | None | $3.89 | $4.68 | $7.59 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $2.00 Typical High $3.55 | Professional | None | $1.82 | $2.00 | $3.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.79 Median $7.08 Typical High $19.50 | Facility | None | $4.79 | $7.08 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $2.69 Typical High $8.91 | Professional | None | $1.95 | $2.69 | $8.91 |
Blue Shield Setting Facility Modifier None Typical Low $10.00 Median $36.31 Typical High $61.66 | Facility | None | $10.00 | $36.31 | $61.66 |
Blue Shield Setting Professional Modifier None Typical Low $2.45 Median $3.47 Typical High $6.31 | Professional | None | $2.45 | $3.47 | $6.31 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $5.13 | Professional | None | $3.16 | $3.16 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $2.75 Median $5.89 Typical High $13.80 | Facility | None | $2.75 | $5.89 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $4.68 Typical High $12.88 | Professional | None | $2.88 | $4.68 | $12.88 |
Contra Costa Health Setting Professional Modifier None Typical Low $3.31 Median $4.37 Typical High $4.37 | Professional | None | $3.31 | $4.37 | $4.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.31 Median $3.98 Typical High $10.47 | Professional | None | $3.31 | $3.98 | $10.47 |
Lucent Health Setting Professional Modifier None Typical Low $3.31 Median $5.01 Typical High $7.76 | Professional | None | $3.31 | $5.01 | $7.76 |
Molina Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Providence Setting Facility Modifier None Typical Low $3.24 Median $5.13 Typical High $13.80 | Facility | None | $3.24 | $5.13 | $13.80 |
Providence Setting Professional Modifier None Typical Low $2.95 Median $4.68 Typical High $9.77 | Professional | None | $2.95 | $4.68 | $9.77 |
Sutter Health Plus Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
United Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.39 Typical High $14.13 | Professional | None | $2.34 | $3.39 | $14.13 |
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 $2.29 Median $6.03 Typical High $14.45 | Facility | 52 · Reduced service | $2.29 | $6.03 | $14.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.91 Median $2.40 Typical High $5.75 | Facility | 53 · Discontinued | $0.91 | $2.40 | $5.75 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.66 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $1.66 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.68 | $0.93 | $0.93 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.69 Median $5.13 Typical High $5.75 | Professional | QW · Waived lab test | $2.69 | $5.13 | $5.75 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $3.16 Median $4.47 Typical High $10.96 | Professional | QW · Waived lab test | $3.16 | $4.47 | $10.96 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | QW · Waived lab test | $13.80 | $13.80 | $13.80 |
Where California sits
The same service costs 12.6 times more in Vermont 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· 20th of 51
$4.68
VT $39.81DC $3.16
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.