How much rates vary
Facilitymedian $21 · 10th to 90th $10 to $100Professionalmedian $9 · 10th to 90th $6 to $27
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 $11.22 Median $22.91 Typical High $69.18 | Facility | None | $11.22 | $22.91 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $11.48 Typical High $16.22 | Professional | None | $10.00 | $11.48 | $16.22 |
Ambetter Setting Professional Modifier None Typical Low $6.61 Median $10.00 Typical High $19.50 | Professional | None | $6.61 | $10.00 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.88 Median $19.95 Typical High $51.29 | Facility | None | $12.88 | $19.95 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $7.08 Typical High $28.18 | Professional | None | $6.31 | $7.08 | $28.18 |
Blue Shield Setting Facility Modifier None Typical Low $25.12 Median $77.62 Typical High $144.54 | Facility | None | $25.12 | $77.62 | $144.54 |
Blue Shield Setting Professional Modifier None Typical Low $5.89 Median $8.51 Typical High $14.45 | Professional | None | $5.89 | $8.51 | $14.45 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $13.80 | Professional | None | $8.32 | $8.32 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $15.85 Typical High $35.48 | Facility | None | $7.08 | $15.85 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $10.23 Typical High $31.62 | Professional | None | $6.17 | $10.23 | $31.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $8.13 Median $11.48 Typical High $11.48 | Professional | None | $8.13 | $11.48 | $11.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $8.91 Median $11.48 Typical High $28.18 | Professional | None | $8.91 | $11.48 | $28.18 |
Lucent Health Setting Professional Modifier None Typical Low $11.75 Median $14.45 Typical High $17.78 | Professional | None | $11.75 | $14.45 | $17.78 |
Molina Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $12.59 | Professional | None | $6.31 | $6.31 | $12.59 |
Providence Setting Facility Modifier None Typical Low $8.13 Median $12.59 Typical High $30.90 | Facility | None | $8.13 | $12.59 | $30.90 |
Providence Setting Professional Modifier None Typical Low $6.17 Median $10.23 Typical High $23.99 | Professional | None | $6.17 | $10.23 | $23.99 |
Sutter Health Plus Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $10.47 | Facility | None | $4.37 | $4.37 | $10.47 |
United Setting Professional Modifier None Typical Low $4.37 Median $6.31 Typical High $26.30 | Professional | None | $4.37 | $6.31 | $26.30 |
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 $5.62 Median $14.45 Typical High $34.67 | Facility | 52 · Reduced service | $5.62 | $14.45 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $5.75 Typical High $13.80 | Facility | 53 · Discontinued | $2.24 | $5.75 | $13.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $4.27 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $1.70 | $2.29 | $2.29 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $7.24 Median $13.80 Typical High $15.14 | Professional | QW · Waived lab test | $7.24 | $13.80 | $15.14 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $8.32 Median $12.59 Typical High $29.51 | Professional | QW · Waived lab test | $8.32 | $12.59 | $29.51 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | QW · Waived lab test | $37.15 | $37.15 | $37.15 |
Where California sits
The same service costs 5.6 times more in Minnesota 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· 24th of 51
$11.22
MN $41.69NJ $7.41
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.