How much rates vary
Facilitymedian $10 · 10th to 90th $4 to $36Professionalmedian $3 · 10th to 90th $2 to $9
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 $28.18 | Facility | None | $4.57 | $9.55 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $4.68 Typical High $5.50 | Professional | None | $3.55 | $4.68 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $1.82 Median $2.40 Typical High $6.17 | Professional | None | $1.82 | $2.40 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.79 Median $7.41 Typical High $19.50 | Facility | None | $4.79 | $7.41 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $2.88 Typical High $8.91 | Professional | None | $2.34 | $2.88 | $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 $5.25 | Professional | None | $2.45 | $3.47 | $5.25 |
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 $13.49 | Facility | None | $2.75 | $5.89 | $13.49 |
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 $3.47 Median $4.27 Typical High $4.27 | Professional | None | $3.47 | $4.27 | $4.27 |
HealthNet Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $20.42 | Professional | None | $15.85 | $15.85 | $20.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.31 Median $4.27 Typical High $10.96 | Professional | None | $3.31 | $4.27 | $10.96 |
Lucent Health Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $5.89 | Professional | None | $3.39 | $3.80 | $5.89 |
Molina Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $4.68 | Professional | None | $2.34 | $2.34 | $4.68 |
Providence Setting Facility Modifier None Typical Low $3.24 Median $4.90 Typical High $12.59 | Facility | None | $3.24 | $4.90 | $12.59 |
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 $10.47 | Professional | None | $2.34 | $3.39 | $10.47 |
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 $14.13 | Facility | 52 · Reduced service | $2.29 | $6.03 | $14.13 |
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 $1.51 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $1.51 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.93 Typical High $0.93 | Professional | 53 · Discontinued | $0.62 | $0.93 | $0.93 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.69 Median $5.13 Typical High $5.62 | Professional | QW · Waived lab test | $2.69 | $5.13 | $5.62 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $3.16 Median $4.68 Typical High $10.96 | Professional | QW · Waived lab test | $3.16 | $4.68 | $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 8.1 times more in Vermont than in New Jersey. 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· 19th of 51
$4.57
VT $22.39NJ $2.75
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.