How much rates vary
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 $12.59 Median $27.54 Typical High $81.28 | Facility | None | $12.59 | $27.54 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $13.49 Typical High $15.85 | Professional | None | $9.33 | $13.49 | $15.85 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $6.92 Typical High $7.94 | Professional | None | $3.80 | $6.92 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.13 Median $21.38 Typical High $56.23 | Facility | None | $14.13 | $21.38 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $8.13 Typical High $25.70 | Professional | None | $5.62 | $8.13 | $25.70 |
Blue Shield Setting Facility Modifier None Typical Low $29.51 Median $91.20 Typical High $173.78 | Facility | None | $29.51 | $91.20 | $173.78 |
Blue Shield Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $18.20 | Professional | None | $7.08 | $10.00 | $18.20 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $14.79 | Professional | None | $9.12 | $9.12 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $17.38 Typical High $38.90 | Facility | None | $7.94 | $17.38 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $12.30 Typical High $38.02 | Professional | None | $7.41 | $12.30 | $38.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $12.59 | Professional | None | $10.00 | $12.59 | $12.59 |
HealthNet Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $9.77 Median $12.59 Typical High $31.62 | Professional | None | $9.77 | $12.59 | $31.62 |
Lucent Health Setting Professional Modifier None Typical Low $9.55 Median $12.88 Typical High $17.38 | Professional | None | $9.55 | $12.88 | $17.38 |
Molina Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $13.80 | Professional | None | $6.92 | $6.92 | $13.80 |
Providence Setting Facility Modifier None Typical Low $9.55 Median $14.79 Typical High $38.02 | Facility | None | $9.55 | $14.79 | $38.02 |
Providence Setting Professional Modifier None Typical Low $7.41 Median $11.48 Typical High $28.84 | Professional | None | $7.41 | $11.48 | $28.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $30.90 | Professional | None | $4.79 | $6.92 | $30.90 |
4 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 $6.61 Median $17.38 Typical High $41.69 | Facility | 52 · Reduced service | $6.61 | $17.38 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.63 Median $6.92 Typical High $16.60 | Facility | 53 · Discontinued | $2.63 | $6.92 | $16.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $6.76 Typical High $6.76 | Professional | 52 · Reduced service | $4.79 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.69 Typical High $2.69 | Professional | 53 · Discontinued | $1.95 | $2.69 | $2.69 |
Where California sits
The same service costs 15.1 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· 18th of 51
$13.18
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.