How much rates vary
Facilitymedian $19 · 10th to 90th $9 to $95Professionalmedian $9 · 10th to 90th $5 to $21
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 $10.47 Median $21.38 Typical High $72.44 | Facility | None | $10.47 | $21.38 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $15.14 | Professional | None | $8.91 | $10.72 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $10.00 | Professional | None | $4.27 | $4.79 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $16.22 Typical High $44.67 | Facility | None | $11.22 | $16.22 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $6.17 Typical High $20.42 | Professional | None | $5.13 | $6.17 | $20.42 |
Blue Shield Setting Facility Modifier None Typical Low $23.44 Median $74.13 Typical High $138.04 | Facility | None | $23.44 | $74.13 | $138.04 |
Blue Shield Setting Professional Modifier None Typical Low $5.62 Median $7.94 Typical High $14.45 | Professional | None | $5.62 | $7.94 | $14.45 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $11.75 | Professional | None | $7.24 | $7.24 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $13.49 Typical High $32.36 | Facility | None | $6.31 | $13.49 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $9.55 Typical High $29.51 | Professional | None | $5.89 | $9.55 | $29.51 |
Contra Costa Health Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $10.00 | Professional | None | $7.94 | $10.00 | $10.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $25.12 | Professional | None | $7.59 | $9.12 | $25.12 |
Lucent Health Setting Professional Modifier None Typical Low $7.59 Median $12.30 Typical High $21.88 | Professional | None | $7.59 | $12.30 | $21.88 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Providence Setting Facility Modifier None Typical Low $7.59 Median $11.48 Typical High $30.20 | Facility | None | $7.59 | $11.48 | $30.20 |
Providence Setting Professional Modifier None Typical Low $5.89 Median $9.12 Typical High $22.91 | Professional | None | $5.89 | $9.12 | $22.91 |
Sutter Health Plus Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $9.12 | Facility | None | $3.80 | $3.80 | $9.12 |
United Setting Professional Modifier None Typical Low $3.80 Median $5.37 Typical High $23.99 | Professional | None | $3.80 | $5.37 | $23.99 |
5 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 $5.25 Median $13.80 Typical High $33.11 | Facility | 52 · Reduced service | $5.25 | $13.80 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.09 Median $5.50 Typical High $13.18 | Facility | 53 · Discontinued | $2.09 | $5.50 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.80 Median $5.37 Typical High $5.37 | Professional | 52 · Reduced service | $3.80 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $2.14 Typical High $2.14 | Professional | 53 · Discontinued | $1.51 | $2.14 | $2.14 |
HealthNet Setting Professional Modifier 90 · Outside lab Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 90 · Outside lab | $50.12 | $50.12 | $50.12 |
Where California sits
The same service costs 10.7 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· 22nd of 51
$10.47
VT $74.13MD $6.92
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.