How much rates vary
Facilitymedian $14 · 10th to 90th $6 to $48Professionalmedian $11 · 10th to 90th $6 to $30
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 $10.00 Median $11.48 Typical High $33.88 | Facility | None | $10.00 | $11.48 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $11.48 Typical High $23.44 | Professional | None | $10.00 | $11.48 | $23.44 |
Ambetter Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $6.76 | Professional | None | $6.03 | $6.03 | $6.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $34.67 | Facility | None | $13.49 | $13.49 | $34.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $37.15 | Professional | None | $9.12 | $10.72 | $37.15 |
CDPHP Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $29.51 Typical High $144.54 | Facility | None | $13.18 | $29.51 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $15.14 Typical High $85.11 | Professional | None | $8.32 | $15.14 | $85.11 |
Emblem Health Setting Facility Modifier None Typical Low $9.12 Median $14.79 Typical High $30.20 | Facility | None | $9.12 | $14.79 | $30.20 |
Emblem Health Setting Professional Modifier None Typical Low $6.31 Median $7.94 Typical High $25.70 | Professional | None | $6.31 | $7.94 | $25.70 |
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 $6.17 Median $13.49 Typical High $15.14 | Professional | None | $6.17 | $13.49 | $15.14 |
Highmark BCBS Setting Facility Modifier None Typical Low $10.72 Median $23.44 Typical High $63.10 | Facility | None | $10.72 | $23.44 | $63.10 |
Highmark BCBS Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
MVP Health Care Setting Facility Modifier None Typical Low $13.18 Median $19.95 Typical High $257.04 | Facility | None | $13.18 | $19.95 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $30.20 | Professional | None | $10.72 | $10.72 | $30.20 |
United Setting Facility Modifier None Typical Low $3.63 Median $13.49 Typical High $16.60 | Facility | None | $3.63 | $13.49 | $16.60 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.94 Typical High $19.95 | Professional | None | $5.62 | $7.94 | $19.95 |
Univera Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $32.36 | Facility | None | $6.17 | $6.17 | $32.36 |
Univera Setting Professional Modifier None Typical Low $6.17 Median $13.49 Typical High $15.85 | Professional | None | $6.17 | $13.49 | $15.85 |
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 Professional Modifier 52 · Reduced service Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.29 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.29 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $13.49 Median $19.95 Typical High $30.20 | Facility | QW · Waived lab test | $13.49 | $19.95 | $30.20 |
Fidelis Setting Professional Modifier QW · Waived lab test Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | QW · Waived lab test | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier QW · Waived lab test Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | QW · Waived lab test | $8.13 | $8.13 | $8.13 |
Where New York sits
The same service costs 10.7 times more in Vermont 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.
New York· 42nd of 51
$12.02
VT $110MD $10.23
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.