How much rates vary
Facilitymedian $7 · 10th to 90th $2 to $22Professionalmedian $2 · 10th to 90th $2 to $5
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 $2.75 Median $5.62 Typical High $16.98 | Facility | None | $2.75 | $5.62 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $2.82 Typical High $3.80 | Professional | None | $2.34 | $2.82 | $3.80 |
Ambetter Setting Professional Modifier None Typical Low $1.20 Median $1.62 Typical High $15.14 | Professional | None | $1.20 | $1.62 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.95 Median $4.47 Typical High $11.75 | Facility | None | $2.95 | $4.47 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $1.78 Typical High $5.37 | Professional | None | $1.41 | $1.78 | $5.37 |
Blue Shield Setting Facility Modifier None Typical Low $6.31 Median $21.88 Typical High $42.66 | Facility | None | $6.31 | $21.88 | $42.66 |
Blue Shield Setting Professional Modifier None Typical Low $1.48 Median $2.09 Typical High $3.16 | Professional | None | $1.48 | $2.09 | $3.16 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $3.09 | Professional | None | $1.91 | $1.91 | $3.09 |
Cigna Setting Facility Modifier None Typical Low $1.66 Median $3.55 Typical High $8.13 | Facility | None | $1.66 | $3.55 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $2.88 Typical High $7.94 | Professional | None | $1.78 | $2.88 | $7.94 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $2.63 | Professional | None | $2.09 | $2.63 | $2.63 |
HealthNet Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2.00 Median $2.63 Typical High $6.61 | Professional | None | $2.00 | $2.63 | $6.61 |
Lucent Health Setting Professional Modifier None Typical Low $2.00 Median $3.09 Typical High $4.47 | Professional | None | $2.00 | $3.09 | $4.47 |
Molina Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Providence Setting Facility Modifier None Typical Low $1.95 Median $3.09 Typical High $7.76 | Facility | None | $1.95 | $3.09 | $7.76 |
Providence Setting Professional Modifier None Typical Low $1.82 Median $2.82 Typical High $5.89 | Professional | None | $1.82 | $2.82 | $5.89 |
Sutter Health Plus Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
United Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
United Setting Professional Modifier None Typical Low $1.41 Median $2.04 Typical High $8.51 | Professional | None | $1.41 | $2.04 | $8.51 |
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 $1.38 Median $3.63 Typical High $8.71 | Facility | 52 · Reduced service | $1.38 | $3.63 | $8.71 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.55 Median $1.45 Typical High $3.47 | Facility | 53 · Discontinued | $0.55 | $1.45 | $3.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.41 Typical High $1.41 | Professional | 52 · Reduced service | $1.00 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.56 Typical High $0.56 | Professional | 53 · Discontinued | $0.40 | $0.56 | $0.56 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $1.62 Median $3.16 Typical High $3.47 | Professional | QW · Waived lab test | $1.62 | $3.16 | $3.47 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $1.91 Median $2.82 Typical High $6.61 | Professional | QW · Waived lab test | $1.91 | $2.82 | $6.61 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | QW · Waived lab test | $8.32 | $8.32 | $8.32 |
Where California sits
The same service costs 17.0 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· 20th of 51
$2.82
VT $32.36MD $1.91
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.