How much rates vary
Facilitymedian $5 · 10th to 90th $2 to $1,288Professionalmedian $2 · 10th to 90th $2 to $7
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 $1.78 Median $2.04 Typical High $2.40 | Facility | None | $1.78 | $2.04 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $2.04 Typical High $2.51 | Professional | None | $1.78 | $2.04 | $2.51 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.07 Median $5.13 Typical High $20.89 | Facility | None | $4.07 | $5.13 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.82 Median $4.37 Typical High $25.70 | Professional | None | $1.82 | $4.37 | $25.70 |
Blue Shield Setting Facility Modifier None Typical Low $48.98 Median $870.96 Typical High $1,905.46 | Facility | None | $48.98 | $870.96 | $1,905.46 |
Blue Shield Setting Professional Modifier None Typical Low $1.66 Median $2.14 Typical High $2.57 | Professional | None | $1.66 | $2.14 | $2.57 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $2.40 Median $3.31 Typical High $3.31 | Professional | None | $2.40 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $5.01 Typical High $5.01 | Professional | None | $2.00 | $5.01 | $5.01 |
Contra Costa Health Setting Professional Modifier None Typical Low $1.82 Median $2.95 Typical High $3.24 | Professional | None | $1.82 | $2.95 | $3.24 |
HealthNet Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1.86 Median $2.24 Typical High $2.69 | Professional | None | $1.86 | $2.24 | $2.69 |
Lucent Health Setting Professional Modifier None Typical Low $13.80 Median $21.38 Typical High $21.38 | Professional | None | $13.80 | $21.38 | $21.38 |
Molina Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Optum Setting Professional Modifier None Typical Low $2.34 Median $2.51 Typical High $2.63 | Professional | None | $2.34 | $2.51 | $2.63 |
Providence Setting Facility Modifier None Typical Low $2.40 Median $3.16 Typical High $3.63 | Facility | None | $2.40 | $3.16 | $3.63 |
Providence Setting Professional Modifier None Typical Low $2.00 Median $5.01 Typical High $5.01 | Professional | None | $2.00 | $5.01 | $5.01 |
Sutter Health Plus Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
United Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $72.44 | Facility | None | $47.86 | $47.86 | $72.44 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.51 Typical High $3.47 | Professional | None | $1.91 | $2.51 | $3.47 |
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 $1.02 Median $1.02 Typical High $1.15 | Facility | 52 · Reduced service | $1.02 | $1.02 | $1.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.41 Median $0.41 Typical High $0.46 | Facility | 53 · Discontinued | $0.41 | $0.41 | $0.46 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $2.19 Median $2.40 Typical High $2.51 | Facility | AF · Specialist physician | $2.19 | $2.40 | $2.51 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $1.66 Median $1.78 Typical High $1.91 | Facility | HO · Master's level | $1.66 | $1.78 | $1.91 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $1.86 Median $2.04 Typical High $2.19 | Facility | TD · Registered nurse | $1.86 | $2.04 | $2.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.98 Median $1.02 Typical High $1.15 | Professional | 52 · Reduced service | $0.98 | $1.02 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.41 Typical High $0.46 | Professional | 53 · Discontinued | $0.39 | $0.41 | $0.46 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $2.19 Median $2.40 Typical High $2.69 | Professional | AF · Specialist physician | $2.19 | $2.40 | $2.69 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $1.66 Median $1.78 Typical High $2.00 | Professional | HO · Master's level | $1.66 | $1.78 | $2.00 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $1.86 Median $2.04 Typical High $2.29 | Professional | TD · Registered nurse | $1.86 | $2.04 | $2.29 |
Where California sits
The same service costs 2.2 times more in North Dakota than in Kentucky. 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· 24th of 51
$2.34
ND $3.55KY $1.62
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.