How much rates vary
Facilitymedian $85 · 10th to 90th $37 to $4,365Professionalmedian $39 · 10th to 90th $32 to $85
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 $33.88 Median $39.81 Typical High $45.71 | Facility | None | $33.88 | $39.81 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $50.12 | Professional | None | $32.36 | $38.90 | $50.12 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $38.02 Typical High $38.02 | Professional | None | $33.11 | $38.02 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $407.38 | Facility | None | $79.43 | $100.00 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $81.28 Typical High $158.49 | Professional | None | $35.48 | $81.28 | $158.49 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $1,000.00 Typical High $6,165.95 | Facility | None | $48.98 | $1,000.00 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $51.29 | Professional | None | $31.62 | $41.69 | $51.29 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $43.65 Median $58.88 Typical High $58.88 | Professional | None | $43.65 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $44.67 | Professional | None | $30.20 | $38.90 | $44.67 |
Contra Costa Health Setting Professional Modifier None Typical Low $35.48 Median $52.48 Typical High $57.54 | Professional | None | $35.48 | $52.48 | $57.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $48.98 | Professional | None | $30.90 | $38.90 | $48.98 |
Lucent Health Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | None | $218.78 | $331.13 | $331.13 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Optum Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $43.65 | Professional | None | $33.88 | $36.31 | $43.65 |
Providence Setting Facility Modifier None Typical Low $41.69 Median $54.95 Typical High $74.13 | Facility | None | $41.69 | $54.95 | $74.13 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $44.67 | Professional | None | $30.20 | $38.90 | $44.67 |
Sutter Health Plus Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,122.02 | Facility | None | $741.31 | $741.31 | $1,122.02 |
United Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $61.66 | Professional | None | $32.36 | $36.31 | $61.66 |
10 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 $19.95 Median $19.95 Typical High $22.91 | Facility | 52 · Reduced service | $19.95 | $19.95 | $22.91 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.12 | Facility | 53 · Discontinued | $7.94 | $7.94 | $9.12 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $42.66 Median $45.71 Typical High $51.29 | Facility | AF · Specialist physician | $42.66 | $45.71 | $51.29 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $32.36 Median $33.88 Typical High $33.88 | Facility | HO · Master's level | $32.36 | $33.88 | $33.88 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $36.31 Median $38.90 Typical High $38.90 | Facility | TD · Registered nurse | $36.31 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.95 Typical High $22.91 | Professional | 52 · Reduced service | $19.05 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $9.12 | Professional | 53 · Discontinued | $7.59 | $7.94 | $9.12 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $42.66 Median $45.71 Typical High $52.48 | Professional | AF · Specialist physician | $42.66 | $45.71 | $52.48 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $32.36 Median $33.88 Typical High $38.02 | Professional | HO · Master's level | $32.36 | $33.88 | $38.02 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $36.31 Median $38.90 Typical High $42.66 | Professional | TD · Registered nurse | $36.31 | $38.90 | $42.66 |
Where California sits
The same service costs 2.1 times more in North Dakota than in Ohio. 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· 17th of 51
$38.90
ND $54.95OH $26.30
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.