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 $6.76 Median $16.60 Typical High $41.69 | Facility | None | $6.76 | $16.60 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $7.94 | Professional | None | $5.25 | $6.92 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $5.25 | Professional | None | $2.63 | $2.63 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $10.23 Typical High $28.18 | Facility | None | $7.08 | $10.23 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $4.07 Typical High $12.88 | Professional | None | $2.82 | $4.07 | $12.88 |
Blue Shield Setting Facility Modifier None Typical Low $14.79 Median $51.29 Typical High $87.10 | Facility | None | $14.79 | $51.29 | $87.10 |
Blue Shield Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $9.12 | Professional | None | $3.55 | $5.13 | $9.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $7.59 | Professional | None | $4.57 | $4.57 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $4.07 Median $8.71 Typical High $19.95 | Facility | None | $4.07 | $8.71 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $6.17 Typical High $19.50 | Professional | None | $3.80 | $6.17 | $19.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.13 Median $6.31 Typical High $6.31 | Professional | None | $5.13 | $6.31 | $6.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.90 Median $6.31 Typical High $16.22 | Professional | None | $4.90 | $6.31 | $16.22 |
Molina Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $5.75 | Professional | None | $2.88 | $2.88 | $5.75 |
Providence Setting Facility Modifier None Typical Low $4.79 Median $7.41 Typical High $21.38 | Facility | None | $4.79 | $7.41 | $21.38 |
Providence Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $14.45 | Professional | None | $3.80 | $5.75 | $14.45 |
Sutter Health Plus Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
United Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $5.75 | Facility | None | $2.40 | $2.40 | $5.75 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.47 Typical High $15.49 | Professional | None | $2.40 | $3.47 | $15.49 |
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 $3.39 Median $8.71 Typical High $20.89 | Facility | 52 · Reduced service | $3.39 | $8.71 | $20.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.35 Median $3.55 Typical High $8.51 | Facility | 53 · Discontinued | $1.35 | $3.55 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.45 Median $3.47 Typical High $3.47 | Professional | 52 · Reduced service | $2.45 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.38 Typical High $1.38 | Professional | 53 · Discontinued | $0.98 | $1.38 | $1.38 |
Where California sits
The same service costs 4.0 times more in Kansas 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· 25th of 51
$6.17
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.