How much rates vary
Facilitymedian $20 · 10th to 90th $11 to $69Professionalmedian $39 · 10th to 90th $11 to $112
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 $11.22 Median $39.81 Typical High $69.18 | Facility | None | $11.22 | $39.81 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $38.90 Typical High $54.95 | Professional | None | $11.22 | $38.90 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $8.71 Median $33.88 Typical High $39.81 | Professional | None | $8.71 | $33.88 | $39.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.22 Median $17.38 Typical High $19.05 | Facility | None | $16.22 | $17.38 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $42.66 Typical High $85.11 | Professional | None | $16.22 | $42.66 | $85.11 |
Blue Shield Setting Professional Modifier None Typical Low $9.12 Median $30.20 Typical High $52.48 | Professional | None | $9.12 | $30.20 | $52.48 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $12.30 Median $44.67 Typical High $54.95 | Professional | None | $12.30 | $44.67 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $39.81 Typical High $64.57 | Professional | None | $12.30 | $39.81 | $64.57 |
Contra Costa Health Setting Professional Modifier None Typical Low $10.96 Median $36.31 Typical High $53.70 | Professional | None | $10.96 | $36.31 | $53.70 |
HealthNet Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $512.86 | Professional | None | $316.23 | $316.23 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10.23 Median $33.88 Typical High $72.44 | Professional | None | $10.23 | $33.88 | $72.44 |
Lucent Health Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | None | $245.47 | $316.23 | $316.23 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $51.29 | Professional | None | $30.20 | $30.20 | $51.29 |
Providence Setting Facility Modifier None Typical Low $11.22 Median $30.90 Typical High $70.79 | Facility | None | $11.22 | $30.90 | $70.79 |
Providence Setting Professional Modifier None Typical Low $12.30 Median $40.74 Typical High $61.66 | Professional | None | $12.30 | $40.74 | $61.66 |
Sutter Health Plus Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $134.90 | Professional | None | $38.90 | $38.90 | $134.90 |
United Setting Professional Modifier None Typical Low $9.77 Median $32.36 Typical High $64.57 | Professional | None | $9.77 | $32.36 | $64.57 |
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 $5.62 Median $6.46 Typical High $22.91 | Facility | 52 · Reduced service | $5.62 | $6.46 | $22.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $2.57 Typical High $9.12 | Facility | 53 · Discontinued | $2.24 | $2.57 | $9.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $15.14 Typical High $22.39 | Professional | 52 · Reduced service | $5.62 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $6.03 Typical High $8.91 | Professional | 53 · Discontinued | $2.24 | $6.03 | $8.91 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 59 · Distinct service | $38.02 | $39.81 | $39.81 |
Where California sits
The same service costs 2.5 times more in Kansas 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· 18th of 51
$38.90
KS $54.95MD $22.39
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.