How much rates vary
Facilitymedian $15 · 10th to 90th $7 to $76Professionalmedian $6 · 10th to 90th $4 to $16
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 $7.59 Median $17.38 Typical High $51.29 | Facility | None | $7.59 | $17.38 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $7.24 Median $8.71 Typical High $11.75 | Professional | None | $7.24 | $8.71 | $11.75 |
Ambetter Setting Professional Modifier None Typical Low $3.31 Median $3.63 Typical High $6.46 | Professional | None | $3.31 | $3.63 | $6.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.91 Median $13.80 Typical High $35.48 | Facility | None | $8.91 | $13.80 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $5.37 Typical High $14.45 | Professional | None | $4.37 | $5.37 | $14.45 |
Blue Shield Setting Facility Modifier None Typical Low $18.62 Median $63.10 Typical High $109.65 | Facility | None | $18.62 | $63.10 | $109.65 |
Blue Shield Setting Professional Modifier None Typical Low $4.47 Median $6.31 Typical High $11.48 | Professional | None | $4.47 | $6.31 | $11.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $9.33 | Professional | None | $5.75 | $5.75 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $10.96 Typical High $25.12 | Facility | None | $5.01 | $10.96 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $7.94 Typical High $23.99 | Professional | None | $4.68 | $7.94 | $23.99 |
Contra Costa Health Setting Professional Modifier None Typical Low $6.46 Median $7.94 Typical High $7.94 | Professional | None | $6.46 | $7.94 | $7.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.17 Median $7.24 Typical High $19.05 | Professional | None | $6.17 | $7.24 | $19.05 |
Lucent Health Setting Professional Modifier None Typical Low $6.03 Median $6.76 Typical High $10.96 | Professional | None | $6.03 | $6.76 | $10.96 |
Molina Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $8.71 | Professional | None | $4.37 | $4.37 | $8.71 |
Providence Setting Facility Modifier None Typical Low $6.03 Median $9.12 Typical High $21.38 | Facility | None | $6.03 | $9.12 | $21.38 |
Providence Setting Professional Modifier None Typical Low $4.68 Median $7.24 Typical High $18.20 | Professional | None | $4.68 | $7.24 | $18.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $7.24 | Facility | None | $3.02 | $3.02 | $7.24 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.37 Typical High $19.50 | Professional | None | $3.02 | $4.37 | $19.50 |
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 $4.17 Median $10.96 Typical High $26.30 | Facility | 52 · Reduced service | $4.17 | $10.96 | $26.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.70 Median $4.37 Typical High $10.47 | Facility | 53 · Discontinued | $1.70 | $4.37 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.09 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $3.09 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.23 | $1.74 | $1.74 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $5.01 Median $7.41 Typical High $10.47 | Professional | QW · Waived lab test | $5.01 | $7.41 | $10.47 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $5.75 Median $8.32 Typical High $19.95 | Professional | QW · Waived lab test | $5.75 | $8.32 | $19.95 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | QW · Waived lab test | $25.12 | $25.12 | $25.12 |
Where California sits
The same service costs 5.8 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· 23rd of 51
$7.94
VT $30.90MD $5.37
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.