How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $19Professionalmedian $4 · 10th to 90th $2 to $11
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 $3.63 Median $4.17 Typical High $12.59 | Facility | None | $3.63 | $4.17 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $4.17 Typical High $6.61 | Professional | None | $3.63 | $4.17 | $6.61 |
Ambetter Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $12.88 | Facility | None | $4.90 | $4.90 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $3.98 Typical High $13.18 | Professional | None | $2.45 | $3.98 | $13.18 |
CDPHP Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $10.72 Typical High $53.70 | Facility | None | $4.79 | $10.72 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $6.76 Typical High $33.88 | Professional | None | $3.55 | $6.76 | $33.88 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $5.62 Typical High $11.22 | Facility | None | $3.47 | $5.62 | $11.22 |
Emblem Health Setting Professional Modifier None Typical Low $2.34 Median $3.47 Typical High $9.55 | Professional | None | $2.34 | $3.47 | $9.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $5.89 | Professional | None | $4.17 | $4.90 | $5.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.98 Median $13.49 Typical High $38.02 | Facility | None | $3.98 | $13.49 | $38.02 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $3.72 | Professional | None | $3.24 | $3.31 | $3.72 |
MVP Health Care Setting Facility Modifier None Typical Low $6.17 Median $10.72 Typical High $257.04 | Facility | None | $6.17 | $10.72 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $10.23 | Professional | None | $3.24 | $3.24 | $10.23 |
United Setting Facility Modifier None Typical Low $1.38 Median $4.90 Typical High $10.47 | Facility | None | $1.38 | $4.90 | $10.47 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.95 Typical High $7.41 | Professional | None | $2.09 | $2.95 | $7.41 |
Univera Setting Facility Modifier None Typical Low $3.24 Median $4.90 Typical High $16.60 | Facility | None | $3.24 | $4.90 | $16.60 |
Univera Setting Professional Modifier None Typical Low $3.24 Median $4.90 Typical High $6.46 | Professional | None | $3.24 | $4.90 | $6.46 |
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 $1.82 Median $1.82 Typical High $2.09 | Professional | 52 · Reduced service | $1.82 | $1.82 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.83 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.83 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $4.90 Median $7.41 Typical High $11.22 | Facility | QW · Waived lab test | $4.90 | $7.41 | $11.22 |
United Setting Professional Modifier QW · Waived lab test Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | QW · Waived lab test | $3.02 | $3.02 | $3.02 |
Where New York sits
The same service costs 9.3 times more in Vermont 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· 33rd of 51
$4.79
VT $33.88GA $3.63
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.