How much rates vary
Facilitymedian $35 · 10th to 90th $15 to $135Professionalmedian $12 · 10th to 90th $7 to $36
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 $15.14 Median $31.62 Typical High $93.33 | Facility | None | $15.14 | $31.62 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $15.49 Typical High $28.18 | Professional | None | $13.80 | $15.49 | $28.18 |
Ambetter Setting Professional Modifier None Typical Low $7.94 Median $10.47 Typical High $10.72 | Professional | None | $7.94 | $10.47 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $30.90 Typical High $85.11 | Facility | None | $21.38 | $30.90 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $9.12 Typical High $36.31 | Professional | None | $6.92 | $9.12 | $36.31 |
Blue Shield Setting Facility Modifier None Typical Low $37.15 Median $104.71 Typical High $194.98 | Facility | None | $37.15 | $104.71 | $194.98 |
Blue Shield Setting Professional Modifier None Typical Low $7.94 Median $11.48 Typical High $20.89 | Professional | None | $7.94 | $11.48 | $20.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $22.39 | Professional | None | $13.80 | $13.80 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $26.30 Typical High $57.54 | Facility | None | $12.02 | $26.30 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $42.66 | Professional | None | $9.33 | $14.13 | $42.66 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.23 Median $19.05 Typical High $19.05 | Professional | None | $10.23 | $19.05 | $19.05 |
HealthNet Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $13.80 Median $17.38 Typical High $45.71 | Professional | None | $13.80 | $17.38 | $45.71 |
Lucent Health Setting Professional Modifier None Typical Low $14.45 Median $18.20 Typical High $21.38 | Professional | None | $14.45 | $18.20 | $21.38 |
Molina Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $20.89 | Professional | None | $10.47 | $10.47 | $20.89 |
Providence Setting Facility Modifier None Typical Low $12.02 Median $20.89 Typical High $51.29 | Facility | None | $12.02 | $20.89 | $51.29 |
Providence Setting Professional Modifier None Typical Low $9.33 Median $15.49 Typical High $34.67 | Professional | None | $9.33 | $15.49 | $34.67 |
Sutter Health Plus Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $17.38 | Facility | None | $7.24 | $7.24 | $17.38 |
United Setting Professional Modifier None Typical Low $7.24 Median $10.47 Typical High $39.81 | Professional | None | $7.24 | $10.47 | $39.81 |
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 $7.59 Median $19.50 Typical High $46.77 | Facility | 52 · Reduced service | $7.59 | $19.50 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $3.02 Median $7.94 Typical High $19.05 | Facility | 53 · Discontinued | $3.02 | $7.94 | $19.05 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $7.76 Typical High $7.76 | Professional | 52 · Reduced service | $6.61 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.09 Typical High $3.09 | Professional | 53 · Discontinued | $2.63 | $3.09 | $3.09 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $12.02 Median $22.39 Typical High $25.12 | Professional | QW · Waived lab test | $12.02 | $22.39 | $25.12 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $13.80 Median $19.95 Typical High $47.86 | Professional | QW · Waived lab test | $13.80 | $19.95 | $47.86 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | QW · Waived lab test | $60.26 | $60.26 | $60.26 |
Where California sits
The same service costs 20.4 times more in Vermont than in Kentucky. 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· 36th of 51
$15.49
VT $229KY $11.22
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.