How much rates vary
Facilitymedian $8 · 10th to 90th $5 to $25Professionalmedian $6 · 10th to 90th $3 to $15
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 $3.98 Median $5.89 Typical High $17.78 | Facility | None | $3.98 | $5.89 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $5.89 Typical High $9.77 | Professional | None | $3.98 | $5.89 | $9.77 |
Ambetter Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $18.20 | Facility | None | $7.08 | $7.08 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $5.50 Typical High $15.85 | Professional | None | $3.47 | $5.50 | $15.85 |
CDPHP Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $15.14 Typical High $57.54 | Facility | None | $6.92 | $15.14 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $9.55 Typical High $33.88 | Professional | None | $5.01 | $9.55 | $33.88 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $10.00 Typical High $15.85 | Facility | None | $7.08 | $10.00 | $15.85 |
Emblem Health Setting Professional Modifier None Typical Low $3.31 Median $4.90 Typical High $13.49 | Professional | None | $3.31 | $4.90 | $13.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.62 Median $6.76 Typical High $7.76 | Professional | None | $5.62 | $6.76 | $7.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.62 Median $17.38 Typical High $89.13 | Facility | None | $5.62 | $17.38 | $89.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
MVP Health Care Setting Facility Modifier None Typical Low $7.94 Median $13.80 Typical High $257.04 | Facility | None | $7.94 | $13.80 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $14.45 | Professional | None | $5.62 | $5.62 | $14.45 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.08 Typical High $8.71 | Facility | None | $6.31 | $7.08 | $8.71 |
United Setting Professional Modifier None Typical Low $2.95 Median $4.17 Typical High $10.47 | Professional | None | $2.95 | $4.17 | $10.47 |
Univera Setting Facility Modifier None Typical Low $4.57 Median $6.17 Typical High $22.91 | Facility | None | $4.57 | $6.17 | $22.91 |
Univera Setting Professional Modifier None Typical Low $4.57 Median $6.92 Typical High $7.94 | Professional | None | $4.57 | $6.92 | $7.94 |
4 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 Professional Modifier 52 · Reduced service Typical Low $2.00 Median $2.00 Typical High $2.95 | Professional | 52 · Reduced service | $2.00 | $2.00 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.79 Median $0.79 Typical High $1.20 | Professional | 53 · Discontinued | $0.79 | $0.79 | $1.20 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $7.08 Median $10.47 Typical High $15.85 | Facility | QW · Waived lab test | $7.08 | $10.47 | $15.85 |
United Setting Professional Modifier QW · Waived lab test Typical Low $3.24 Median $3.89 Typical High $3.89 | Professional | QW · Waived lab test | $3.24 | $3.89 | $3.89 |
Where New York sits
The same service costs 9.3 times more in Vermont 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.
New York· 40th of 51
$6.17
VT $45.71NJ $4.90
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.