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 $3.47 Median $5.01 Typical High $10.47 | Facility | None | $3.47 | $5.01 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $4.79 Typical High $10.96 | Professional | None | $3.47 | $4.79 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $6.03 Typical High $10.00 | Professional | None | $2.57 | $6.03 | $10.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.57 Median $6.92 Typical High $17.78 | Facility | None | $4.57 | $6.92 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.62 Median $3.80 Typical High $10.00 | Professional | None | $1.62 | $3.80 | $10.00 |
CareSource Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
CareSource Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $5.13 | Professional | None | $3.39 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $11.48 Typical High $28.18 | Facility | None | $5.13 | $11.48 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $5.75 Typical High $7.76 | Professional | None | $3.24 | $5.75 | $7.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5.75 Median $7.76 Typical High $19.05 | Professional | None | $5.75 | $7.76 | $19.05 |
United Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.80 Typical High $10.96 | Professional | None | $2.34 | $3.80 | $10.96 |
2 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 Professional Modifier 52 · Reduced service Typical Low $1.74 Median $2.19 Typical High $2.51 | Professional | 52 · Reduced service | $1.74 | $2.19 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.87 Typical High $1.00 | Professional | 53 · Discontinued | $0.69 | $0.87 | $1.00 |
Where Georgia sits
The same service costs 17.8 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.
Georgia· 41st of 51
$4.57
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.