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 $28.18 Median $74.13 Typical High $194.98 | Facility | None | $28.18 | $74.13 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $31.62 Typical High $31.62 | Professional | None | $28.18 | $31.62 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $47.86 Typical High $131.83 | Facility | None | $32.36 | $47.86 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $31.62 Typical High $123.03 | Professional | None | $13.18 | $31.62 | $123.03 |
Blue Shield Setting Facility Modifier None Typical Low $60.26 Median $213.80 Typical High $398.11 | Facility | None | $60.26 | $213.80 | $398.11 |
Blue Shield Setting Professional Modifier None Typical Low $16.60 Median $23.44 Typical High $95.50 | Professional | None | $16.60 | $23.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $47.86 Typical High $93.33 | Facility | None | $21.38 | $47.86 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $35.48 | Professional | None | $26.30 | $28.84 | $35.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $70.79 | Professional | None | $26.30 | $28.84 | $70.79 |
Lucent Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $44.67 Typical High $89.13 | Facility | None | $24.55 | $44.67 | $89.13 |
Providence Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $28.84 | Professional | None | $14.13 | $14.13 | $28.84 |
Sutter Health Plus Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $26.30 | Facility | None | $11.22 | $11.22 | $26.30 |
United Setting Professional Modifier None Typical Low $11.22 Median $15.85 Typical High $117.49 | Professional | None | $11.22 | $15.85 | $117.49 |
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 $14.13 Median $37.15 Typical High $107.15 | Facility | 52 · Reduced service | $14.13 | $37.15 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.62 Median $14.79 Typical High $42.66 | Facility | 53 · Discontinued | $5.62 | $14.79 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $12.59 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.01 | $6.31 | $6.31 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | KX · Policy requirements met | $41.69 | $41.69 | $41.69 |
Where California sits
The same service costs 5.6 times more in Alaska than in Delaware. 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· 7th of 51
$39.81
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.