How much rates vary
Facilitymedian $49 · 10th to 90th $22 to $224Professionalmedian $27 · 10th to 90th $12 to $178
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 $23.44 Median $56.23 Typical High $147.91 | Facility | None | $23.44 | $56.23 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $23.99 Typical High $28.84 | Professional | None | $21.38 | $23.99 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $10.23 Median $13.80 Typical High $19.05 | Professional | None | $10.23 | $13.80 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $36.31 Typical High $100.00 | Facility | None | $25.12 | $36.31 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $25.70 Typical High $87.10 | Professional | None | $11.48 | $25.70 | $87.10 |
Blue Shield Setting Facility Modifier None Typical Low $47.86 Median $162.18 Typical High $309.03 | Facility | None | $47.86 | $162.18 | $309.03 |
Blue Shield Setting Professional Modifier None Typical Low $12.59 Median $17.78 Typical High $57.54 | Professional | None | $12.59 | $17.78 | $57.54 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $269.15 | Professional | None | $16.22 | $16.22 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $36.31 Typical High $72.44 | Facility | None | $16.60 | $36.31 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $26.30 Typical High $109.65 | Professional | None | $13.18 | $26.30 | $109.65 |
Contra Costa Health Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $27.54 | Professional | None | $18.20 | $22.39 | $27.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $22.39 Typical High $53.70 | Professional | None | $20.42 | $22.39 | $53.70 |
Lucent Health Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | None | $151.36 | $177.83 | $177.83 |
Providence Setting Facility Modifier None Typical Low $19.05 Median $33.88 Typical High $67.61 | Facility | None | $19.05 | $33.88 | $67.61 |
Providence Setting Professional Modifier None Typical Low $13.49 Median $26.92 Typical High $109.65 | Professional | None | $13.49 | $26.92 | $109.65 |
Sutter Health Plus Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $20.42 | Facility | None | $8.51 | $8.51 | $20.42 |
United Setting Professional Modifier None Typical Low $12.02 Median $20.42 Typical High $89.13 | Professional | None | $12.02 | $20.42 | $89.13 |
5 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 $11.75 Median $30.90 Typical High $74.13 | Facility | 52 · Reduced service | $11.75 | $30.90 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.68 Median $12.30 Typical High $29.51 | Facility | 53 · Discontinued | $4.68 | $12.30 | $29.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $12.02 Typical High $12.02 | Professional | 52 · Reduced service | $9.55 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.79 Typical High $4.79 | Professional | 53 · Discontinued | $3.80 | $4.79 | $4.79 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $10.23 Median $10.23 Typical High $18.20 | Professional | 90 · Outside lab | $10.23 | $10.23 | $18.20 |
Where California sits
The same service costs 4.6 times more in Vermont than in Illinois. 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
$30.20
VT $70.79IL $15.49
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.