How much rates vary
Facilitymedian $40 · 10th to 90th $19 to $87Professionalmedian $19 · 10th to 90th $12 to $65
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 $37.15 Median $37.15 Typical High $60.26 | Facility | None | $37.15 | $37.15 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $37.15 Typical High $37.15 | Professional | None | $17.78 | $37.15 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $43.65 Typical High $117.49 | Facility | None | $29.51 | $43.65 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $109.65 | Professional | None | $12.02 | $13.49 | $109.65 |
Blue Shield Setting Facility Modifier None Typical Low $17.38 Median $56.23 Typical High $70.79 | Facility | None | $17.38 | $56.23 | $70.79 |
Blue Shield Setting Professional Modifier None Typical Low $13.49 Median $19.50 Typical High $28.84 | Professional | None | $13.49 | $19.50 | $28.84 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $31.62 | Professional | None | $19.05 | $19.05 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $38.90 Typical High $81.28 | Facility | None | $15.85 | $38.90 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $31.62 | Professional | None | $12.88 | $12.88 | $31.62 |
Contra Costa Health Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $26.30 | Professional | None | $23.99 | $26.30 | $26.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.42 Median $26.30 Typical High $64.57 | Professional | None | $20.42 | $26.30 | $64.57 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $28.84 Typical High $69.18 | Facility | None | $18.20 | $28.84 | $69.18 |
Providence Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $23.99 | Professional | None | $12.88 | $12.88 | $23.99 |
Sutter Health Plus Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $23.99 | Facility | None | $10.00 | $10.00 | $23.99 |
United Setting Professional Modifier None Typical Low $10.00 Median $14.45 Typical High $64.57 | Professional | None | $10.00 | $14.45 | $64.57 |
7 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 $18.62 Median $30.90 Typical High $102.33 | Facility | 52 · Reduced service | $18.62 | $30.90 | $102.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.41 Median $12.30 Typical High $40.74 | Facility | 53 · Discontinued | $7.41 | $12.30 | $40.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $18.62 Typical High $18.62 | Professional | 52 · Reduced service | $10.96 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $7.41 Typical High $7.41 | Professional | 53 · Discontinued | $4.37 | $7.41 | $7.41 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $16.60 Median $31.62 Typical High $34.67 | Professional | QW · Waived lab test | $16.60 | $31.62 | $34.67 |
Kaiser Permanente Setting Professional Modifier QW · Waived lab test Typical Low $19.05 Median $28.84 Typical High $67.61 | Professional | QW · Waived lab test | $19.05 | $28.84 | $67.61 |
Sutter Health Plus Setting Professional Modifier QW · Waived lab test Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | QW · Waived lab test | $74.13 | $74.13 | $74.13 |
Where California sits
The same service costs 3.6 times more in Hawaii than in Maryland. 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· 39th of 51
$19.50
HI $54.95MD $15.14
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.