How much rates vary
Facilitymedian $10 · 10th to 90th $4 to $35Professionalmedian $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 $4.27 Median $8.91 Typical High $26.30 | Facility | None | $4.27 | $8.91 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $4.37 Typical High $5.50 | Professional | None | $3.39 | $4.37 | $5.50 |
Ambetter Setting Professional Modifier None Typical Low $1.23 Median $2.24 Typical High $4.07 | Professional | None | $1.23 | $2.24 | $4.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $6.92 Typical High $18.20 | Facility | None | $4.47 | $6.92 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.69 Typical High $8.91 | Professional | None | $2.19 | $2.69 | $8.91 |
Blue Shield Setting Facility Modifier None Typical Low $9.33 Median $33.88 Typical High $58.88 | Facility | None | $9.33 | $33.88 | $58.88 |
Blue Shield Setting Professional Modifier None Typical Low $2.29 Median $3.24 Typical High $5.89 | Professional | None | $2.29 | $3.24 | $5.89 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.79 | Professional | None | $2.95 | $2.95 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $5.50 Typical High $12.59 | Facility | None | $2.57 | $5.50 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $4.07 Typical High $12.02 | Professional | None | $2.34 | $4.07 | $12.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.95 Median $4.07 Typical High $4.07 | Professional | None | $2.95 | $4.07 | $4.07 |
HealthNet Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3.09 Median $3.63 Typical High $10.23 | Professional | None | $3.09 | $3.63 | $10.23 |
Lucent Health Setting Professional Modifier None Typical Low $3.02 Median $4.07 Typical High $5.50 | Professional | None | $3.02 | $4.07 | $5.50 |
Molina Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $4.37 | Professional | None | $2.19 | $2.19 | $4.37 |
Providence Setting Facility Modifier None Typical Low $3.02 Median $4.79 Typical High $14.13 | Facility | None | $3.02 | $4.79 | $14.13 |
Providence Setting Professional Modifier None Typical Low $2.34 Median $3.63 Typical High $9.12 | Professional | None | $2.34 | $3.63 | $9.12 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | None | $12.88 | $12.88 | $12.88 |
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 $1.55 Median $2.19 Typical High $9.77 | Professional | None | $1.55 | $2.19 | $9.77 |
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 $2.14 Median $5.62 Typical High $13.49 | Facility | 52 · Reduced service | $2.14 | $5.62 | $13.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.85 Median $2.24 Typical High $5.37 | Facility | 53 · Discontinued | $0.85 | $2.24 | $5.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.55 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $1.55 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.63 | $0.87 | $0.87 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $2.51 Median $4.79 Typical High $5.37 | Professional | QW · Waived lab test | $2.51 | $4.79 | $5.37 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $2.95 Median $4.27 Typical High $10.23 | Professional | QW · Waived lab test | $2.95 | $4.27 | $10.23 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | QW · Waived lab test | $12.88 | $12.88 | $12.88 |
Where California sits
The same service costs 10.2 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
$4.27
VT $28.18MD $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.