How much rates vary
Facilitymedian $6 · 10th to 90th $4 to $22Professionalmedian $5 · 10th to 90th $3 to $13
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 $4.27 Median $4.90 Typical High $14.45 | Facility | None | $4.27 | $4.90 | $14.45 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.90 Typical High $8.13 | Professional | None | $4.27 | $4.90 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $15.14 | Facility | None | $5.75 | $5.75 | $15.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $4.57 Typical High $15.14 | Professional | None | $2.88 | $4.57 | $15.14 |
CDPHP Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $5.62 Median $12.88 Typical High $63.10 | Facility | None | $5.62 | $12.88 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $7.94 Typical High $52.48 | Professional | None | $4.07 | $7.94 | $52.48 |
Emblem Health Setting Facility Modifier None Typical Low $4.47 Median $6.92 Typical High $12.88 | Facility | None | $4.47 | $6.92 | $12.88 |
Emblem Health Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $11.22 | Professional | None | $2.69 | $4.07 | $11.22 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $7.59 | Professional | None | $4.90 | $5.75 | $7.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $4.68 Median $12.59 Typical High $42.66 | Facility | None | $4.68 | $12.59 | $42.66 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $4.07 | Professional | None | $3.89 | $3.89 | $4.07 |
MVP Health Care Setting Facility Modifier None Typical Low $6.61 Median $11.48 Typical High $257.04 | Facility | None | $6.61 | $11.48 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $30.20 | Professional | None | $4.68 | $4.68 | $30.20 |
United Setting Facility Modifier None Typical Low $5.25 Median $5.75 Typical High $7.24 | Facility | None | $5.25 | $5.75 | $7.24 |
United Setting Professional Modifier None Typical Low $2.45 Median $3.80 Typical High $9.33 | Professional | None | $2.45 | $3.80 | $9.33 |
Univera Setting Facility Modifier None Typical Low $3.80 Median $5.13 Typical High $14.45 | Facility | None | $3.80 | $5.13 | $14.45 |
Univera Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $17.38 | Professional | None | $3.80 | $5.75 | $17.38 |
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 $2.14 Median $2.14 Typical High $2.45 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.98 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.98 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $5.75 Median $8.71 Typical High $12.88 | Facility | QW · Waived lab test | $5.75 | $8.71 | $12.88 |
United Setting Professional Modifier QW · Waived lab test Typical Low $3.47 Median $3.47 Typical High $3.55 | Professional | QW · Waived lab test | $3.47 | $3.47 | $3.55 |
Where New York sits
The same service costs 12.9 times more in Vermont than in Alabama. 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· 36th of 51
$5.50
VT $51.29AL $3.98
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.