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 $10.47 Median $11.48 Typical High $25.70 | Facility | None | $10.47 | $11.48 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $12.30 | Professional | None | $10.00 | $10.00 | $12.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $35.48 | Facility | None | $13.49 | $13.49 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $12.88 Typical High $33.11 | Professional | None | $6.76 | $12.88 | $33.11 |
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 $28.84 Typical High $38.90 | Facility | None | $13.18 | $28.84 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $19.50 Typical High $64.57 | Professional | None | $9.55 | $19.50 | $64.57 |
Emblem Health Setting Facility Modifier None Typical Low $12.02 Median $17.78 Typical High $30.20 | Facility | None | $12.02 | $17.78 | $30.20 |
Emblem Health Setting Professional Modifier None Typical Low $6.31 Median $9.55 Typical High $26.30 | Professional | None | $6.31 | $9.55 | $26.30 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.72 Median $13.49 Typical High $15.14 | Professional | None | $10.72 | $13.49 | $15.14 |
Highmark BCBS Setting Facility Modifier None Typical Low $10.72 Median $29.51 Typical High $245.47 | Facility | None | $10.72 | $29.51 | $245.47 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $22.91 Typical High $257.04 | Facility | None | $13.80 | $22.91 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $28.18 | Professional | None | $10.96 | $10.96 | $28.18 |
United Setting Facility Modifier None Typical Low $12.30 Median $13.49 Typical High $16.98 | Facility | None | $12.30 | $13.49 | $16.98 |
United Setting Professional Modifier None Typical Low $5.75 Median $8.71 Typical High $20.42 | Professional | None | $5.75 | $8.71 | $20.42 |
Univera Setting Facility Modifier None Typical Low $8.91 Median $10.72 Typical High $23.99 | Facility | None | $8.91 | $10.72 | $23.99 |
Univera Setting Professional Modifier None Typical Low $8.91 Median $13.49 Typical High $15.85 | Professional | None | $8.91 | $13.49 | $15.85 |
3 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 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 90 · Outside lab | $9.12 | $9.12 | $9.12 |
Where New York sits
The same service costs 4.0 times more in Kansas than in Georgia. 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· 32nd of 51
$12.02
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.