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 $4.57 Median $5.37 Typical High $5.37 | Facility | None | $4.57 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $8.13 | Professional | None | $4.17 | $4.90 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $29.51 Typical High $79.43 | Professional | None | $5.75 | $29.51 | $79.43 |
Blue Shield Setting Facility Modifier None Typical Low $15.49 Median $38.02 Typical High $54.95 | Facility | None | $15.49 | $38.02 | $54.95 |
Blue Shield Setting Professional Modifier None Typical Low $3.24 Median $4.57 Typical High $5.75 | Professional | None | $3.24 | $4.57 | $5.75 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $5.37 Median $6.46 Typical High $6.46 | Professional | None | $5.37 | $6.46 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $5.37 Median $24.55 Typical High $36.31 | Professional | None | $5.37 | $24.55 | $36.31 |
Contra Costa Health Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $6.92 | Professional | None | $5.75 | $6.31 | $6.92 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4.37 Median $5.01 Typical High $10.96 | Professional | None | $4.37 | $5.01 | $10.96 |
Lucent Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $162.18 | Professional | None | $144.54 | $144.54 | $162.18 |
Molina Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
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 $4.57 Median $6.76 Typical High $16.60 | Facility | None | $4.57 | $6.76 | $16.60 |
Providence Setting Professional Modifier None Typical Low $4.57 Median $7.94 Typical High $19.05 | Professional | None | $4.57 | $7.94 | $19.05 |
Sutter Health Plus Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.47 Typical High $7.41 | Professional | None | $2.95 | $4.47 | $7.41 |
2 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 Professional Modifier 52 · Reduced service Typical Low $2.04 Median $2.29 Typical High $2.69 | Professional | 52 · Reduced service | $2.04 | $2.29 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.81 Median $0.91 Typical High $1.07 | Professional | 53 · Discontinued | $0.81 | $0.91 | $1.07 |
Where California sits
The same service costs 2.3 times more in Kansas than in Pennsylvania. 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· 25th of 51
$5.37
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.