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 $23.44 Median $25.12 Typical High $28.84 | Facility | None | $23.44 | $25.12 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $38.90 | Professional | None | $22.91 | $25.70 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $33.11 | Professional | None | $25.70 | $26.92 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $26.30 Median $33.11 Typical High $138.04 | Facility | None | $26.30 | $33.11 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $38.02 | Professional | None | $26.30 | $28.18 | $38.02 |
Blue Shield Setting Facility Modifier None Typical Low $31.62 Median $47.86 Typical High $93.33 | Facility | None | $31.62 | $47.86 | $93.33 |
Blue Shield Setting Professional Modifier None Typical Low $15.49 Median $21.88 Typical High $25.12 | Professional | None | $15.49 | $21.88 | $25.12 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $38.90 | Professional | None | $27.54 | $28.18 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $38.02 | Professional | None | $22.91 | $25.70 | $38.02 |
Contra Costa Health Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $38.02 | Professional | None | $19.95 | $26.92 | $38.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $46.77 | Professional | None | $21.88 | $29.51 | $46.77 |
Lucent Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $38.90 | Professional | None | $23.44 | $23.44 | $38.90 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $25.12 Median $31.62 Typical High $41.69 | Facility | None | $25.12 | $31.62 | $41.69 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $25.70 Typical High $37.15 | Professional | None | $22.91 | $25.70 | $37.15 |
Sutter Health Plus Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | None | $67.61 | $67.61 | $75.86 |
United Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $95.50 | Facility | None | $61.66 | $61.66 | $95.50 |
United Setting Professional Modifier None Typical Low $19.95 Median $24.55 Typical High $40.74 | Professional | None | $19.95 | $24.55 | $40.74 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 25 · Same-day visit | $28.18 | $28.18 | $28.18 |
Providence Setting Professional Modifier HG · Opioid treatment program Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | HG · Opioid treatment program | $19.05 | $19.05 | $19.05 |
Where California sits
The same service costs 3.0 times more in Alaska than in New Jersey. 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
$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.