How much rates vary
Facilitymedian $28 · 10th to 90th $12 to $100Professionalmedian $11 · 10th to 90th $6 to $25
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 $10.96 Median $25.70 Typical High $67.61 | Facility | None | $10.96 | $25.70 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $20.89 | Professional | None | $10.96 | $12.30 | $20.89 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $25.12 Typical High $69.18 | Facility | None | $16.98 | $25.12 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $6.61 Typical High $22.39 | Professional | None | $5.89 | $6.61 | $22.39 |
Blue Shield Setting Facility Modifier None Typical Low $26.30 Median $75.86 Typical High $141.25 | Facility | None | $26.30 | $75.86 | $141.25 |
Blue Shield Setting Professional Modifier None Typical Low $5.75 Median $8.13 Typical High $14.13 | Professional | None | $5.75 | $8.13 | $14.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $18.20 | Professional | None | $11.22 | $11.22 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $20.89 Typical High $46.77 | Facility | None | $9.33 | $20.89 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $15.49 Typical High $39.81 | Professional | None | $8.91 | $15.49 | $39.81 |
Contra Costa Health Setting Professional Modifier None Typical Low $2.95 Median $15.14 Typical High $15.14 | Professional | None | $2.95 | $15.14 | $15.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.22 Median $15.14 Typical High $37.15 | Professional | None | $11.22 | $15.14 | $37.15 |
Molina Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | None | $8.32 | $8.32 | $16.60 |
Providence Setting Facility Modifier None Typical Low $9.12 Median $16.60 Typical High $38.90 | Facility | None | $9.12 | $16.60 | $38.90 |
Providence Setting Professional Modifier None Typical Low $8.91 Median $14.13 Typical High $30.20 | Professional | None | $8.91 | $14.13 | $30.20 |
Sutter Health Plus Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
United Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $13.80 | Facility | None | $5.89 | $5.89 | $13.80 |
United Setting Professional Modifier None Typical Low $5.89 Median $8.32 Typical High $33.11 | Professional | None | $5.89 | $8.32 | $33.11 |
6 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 $5.37 Median $14.13 Typical High $33.88 | Facility | 52 · Reduced service | $5.37 | $14.13 | $33.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.19 Median $5.62 Typical High $13.49 | Facility | 53 · Discontinued | $2.19 | $5.62 | $13.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.90 Median $5.62 Typical High $6.03 | Professional | 52 · Reduced service | $4.90 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $2.24 Typical High $2.40 | Professional | 53 · Discontinued | $1.95 | $2.24 | $2.40 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $9.55 Median $18.20 Typical High $19.95 | Professional | QW · Waived lab test | $9.55 | $18.20 | $19.95 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $11.22 Median $16.60 Typical High $38.90 | Professional | QW · Waived lab test | $11.22 | $16.60 | $38.90 |
Where California sits
The same service costs 3.3 times more in Kansas than in New Jersey. 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· 34th of 51
$12.59
KS $32.36NJ $9.77
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.