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 $5.50 Median $14.45 Typical High $34.67 | Facility | None | $5.50 | $14.45 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $4.07 Median $5.50 Typical High $5.62 | Professional | None | $4.07 | $5.50 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $10.96 Typical High $28.84 | Facility | None | $7.08 | $10.96 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $4.27 Typical High $10.72 | Professional | None | $2.34 | $4.27 | $10.72 |
Blue Shield Setting Facility Modifier None Typical Low $13.18 Median $43.65 Typical High $72.44 | Facility | None | $13.18 | $43.65 | $72.44 |
Blue Shield Setting Professional Modifier None Typical Low $2.95 Median $4.17 Typical High $7.76 | Professional | None | $2.95 | $4.17 | $7.76 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $7.59 | Professional | None | $4.68 | $4.68 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $8.71 Typical High $19.50 | Facility | None | $3.89 | $8.71 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $3.16 Median $5.25 Typical High $15.14 | Professional | None | $3.16 | $5.25 | $15.14 |
Contra Costa Health Setting Professional Modifier None Typical Low $4.68 Median $6.31 Typical High $6.31 | Professional | None | $4.68 | $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 $3.47 Median $3.47 Typical High $6.92 | Professional | None | $3.47 | $3.47 | $6.92 |
Providence Setting Facility Modifier None Typical Low $4.27 Median $6.92 Typical High $15.49 | Facility | None | $4.27 | $6.92 | $15.49 |
Providence Setting Professional Modifier None Typical Low $3.31 Median $5.37 Typical High $11.75 | Professional | None | $3.31 | $5.37 | $11.75 |
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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.07 Typical High $13.49 | Professional | None | $3.47 | $4.07 | $13.49 |
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 $2.75 Median $7.24 Typical High $17.38 | Facility | 52 · Reduced service | $2.75 | $7.24 | $17.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.12 Median $2.88 Typical High $6.92 | Facility | 53 · Discontinued | $1.12 | $2.88 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.24 Median $2.82 Typical High $2.82 | Professional | 52 · Reduced service | $2.24 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $1.12 Typical High $1.12 | Professional | 53 · Discontinued | $0.89 | $1.12 | $1.12 |
Where California sits
The same service costs 3.9 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· 26th of 51
$5.75
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.