How much rates vary
Facilitymedian $2 · 10th to 90th $2 to $8Professionalmedian $2 · 10th to 90th $1 to $5
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 $1.66 Median $1.91 Typical High $5.62 | Facility | None | $1.66 | $1.91 | $5.62 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.91 Typical High $4.27 | Professional | None | $1.66 | $1.91 | $4.27 |
Ambetter Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $5.89 | Facility | None | $2.24 | $2.24 | $5.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.12 Median $2.00 Typical High $6.17 | Professional | None | $1.12 | $2.00 | $6.17 |
CDPHP Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Cigna Setting Facility Modifier None Typical Low $2.19 Median $5.13 Typical High $24.55 | Facility | None | $2.19 | $5.13 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $3.02 Typical High $14.13 | Professional | None | $1.78 | $3.02 | $14.13 |
Emblem Health Setting Facility Modifier None Typical Low $1.00 Median $2.24 Typical High $5.01 | Facility | None | $1.00 | $2.24 | $5.01 |
Emblem Health Setting Professional Modifier None Typical Low $1.32 Median $2.57 Typical High $2.95 | Professional | None | $1.32 | $2.57 | $2.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $2.57 | Professional | None | $1.91 | $2.24 | $2.57 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.95 Median $4.57 Typical High $33.11 | Facility | None | $1.95 | $4.57 | $33.11 |
MVP Health Care Setting Facility Modifier None Typical Low $2.82 Median $4.47 Typical High $257.04 | Facility | None | $2.82 | $4.47 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $4.68 | Professional | None | $1.82 | $1.82 | $4.68 |
United Setting Facility Modifier None Typical Low $2.04 Median $2.24 Typical High $2.82 | Facility | None | $2.04 | $2.24 | $2.82 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.45 Typical High $3.39 | Professional | None | $1.00 | $1.45 | $3.39 |
Univera Setting Facility Modifier None Typical Low $1.48 Median $2.04 Typical High $5.75 | Facility | None | $1.48 | $2.04 | $5.75 |
Univera Setting Professional Modifier None Typical Low $1.48 Median $2.24 Typical High $2.69 | Professional | None | $1.48 | $2.24 | $2.69 |
6 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 $0.83 Median $0.83 Typical High $0.95 | Professional | 52 · Reduced service | $0.83 | $0.83 | $0.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.38 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.38 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $2.24 Median $3.39 Typical High $5.01 | Facility | QW · Waived lab test | $2.24 | $3.39 | $5.01 |
Fidelis Setting Professional Modifier QW · Waived lab test Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | QW · Waived lab test | $0.81 | $0.81 | $0.81 |
Highmark BCBS Setting Professional Modifier QW · Waived lab test Typical Low $1.35 Median $1.48 Typical High $3.47 | Professional | QW · Waived lab test | $1.35 | $1.48 | $3.47 |
United Setting Professional Modifier QW · Waived lab test Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | QW · Waived lab test | $1.38 | $1.38 | $1.38 |
Where New York sits
The same service costs 20.4 times more in Vermont than in Washington, DC. 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· 44th of 51
$2.14
VT $37.15DC $1.82
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.