How much rates vary
Facilitymedian $18 · 10th to 90th $10 to $29Professionalmedian $10 · 10th to 90th $7 to $74
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 $8.32 Median $11.22 Typical High $66.07 | Facility | None | $8.32 | $11.22 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $13.49 | Professional | None | $8.32 | $9.12 | $13.49 |
Ambetter Setting Professional Modifier None Typical Low $7.41 Median $10.72 Typical High $24.55 | Professional | None | $7.41 | $10.72 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.77 Median $10.47 Typical High $11.48 | Facility | None | $9.77 | $10.47 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $10.00 Typical High $31.62 | Professional | None | $7.41 | $10.00 | $31.62 |
Blue Shield Setting Facility Modifier None Typical Low $9.33 Median $22.39 Typical High $34.67 | Facility | None | $9.33 | $22.39 | $34.67 |
Blue Shield Setting Professional Modifier None Typical Low $6.76 Median $9.77 Typical High $12.88 | Professional | None | $6.76 | $9.77 | $12.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $31.62 | Professional | None | $8.91 | $10.72 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $15.49 | Professional | None | $8.32 | $9.12 | $15.49 |
Contra Costa Health Setting Professional Modifier None Typical Low $9.55 Median $11.48 Typical High $14.79 | Professional | None | $9.55 | $11.48 | $14.79 |
HealthNet Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $25.70 | Professional | None | $11.48 | $17.38 | $25.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $25.70 | Professional | None | $7.76 | $8.91 | $25.70 |
Lucent Health Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Professional | None | $74.13 | $74.13 | $79.43 |
Molina Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $70.79 | Professional | None | $30.90 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $8.32 Median $13.18 Typical High $25.70 | Facility | None | $8.32 | $13.18 | $25.70 |
Providence Setting Professional Modifier None Typical Low $8.32 Median $8.91 Typical High $16.22 | Professional | None | $8.32 | $8.91 | $16.22 |
Sutter Health Plus Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $15.85 | Professional | None | $6.46 | $8.91 | $15.85 |
7 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 $4.17 Median $4.68 Typical High $33.11 | Facility | 52 · Reduced service | $4.17 | $4.68 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.66 Median $1.86 Typical High $13.18 | Facility | 53 · Discontinued | $1.66 | $1.86 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $4.17 Typical High $4.68 | Professional | 52 · Reduced service | $3.98 | $4.17 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.66 Typical High $1.86 | Professional | 53 · Discontinued | $1.58 | $1.66 | $1.86 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $7.94 Median $8.51 Typical High $8.71 | Professional | 59 · Distinct service | $7.94 | $8.51 | $8.71 |
Ambetter Setting Professional Modifier 76 · Repeat, same provider Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | 76 · Repeat, same provider | $7.59 | $7.59 | $8.91 |
Ambetter Setting Professional Modifier 77 · Repeat, other provider Typical Low $6.92 Median $7.59 Typical High $8.51 | Professional | 77 · Repeat, other provider | $6.92 | $7.59 | $8.51 |
Where California sits
The same service costs 2.5 times more in Alaska 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· 34th of 51
$10.00
AK $20.42MD $8.32
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.