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 $12.30 Median $14.13 Typical High $42.66 | Facility | None | $12.30 | $14.13 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $21.88 | Professional | None | $12.59 | $14.13 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $43.65 | Facility | None | $16.60 | $16.60 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $13.18 Typical High $45.71 | Professional | None | $8.32 | $13.18 | $45.71 |
CDPHP Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $37.15 Typical High $181.97 | Facility | None | $16.22 | $37.15 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $22.91 Typical High $109.65 | Professional | None | $11.48 | $22.91 | $109.65 |
Emblem Health Setting Facility Modifier None Typical Low $8.51 Median $17.78 Typical High $38.02 | Facility | None | $8.51 | $17.78 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $32.36 | Professional | None | $7.94 | $10.00 | $32.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.61 Median $15.85 Typical High $18.62 | Professional | None | $6.61 | $15.85 | $18.62 |
Highmark BCBS Setting Facility Modifier None Typical Low $13.18 Median $30.90 Typical High $87.10 | Facility | None | $13.18 | $30.90 | $87.10 |
Highmark BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $21.88 Typical High $257.04 | Facility | None | $13.80 | $21.88 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $34.67 | Professional | None | $13.49 | $13.49 | $34.67 |
United Setting Facility Modifier None Typical Low $15.14 Median $16.60 Typical High $75.86 | Facility | None | $15.14 | $16.60 | $75.86 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.96 Typical High $25.12 | Professional | None | $7.08 | $10.96 | $25.12 |
Univera Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $47.86 | Facility | None | $6.61 | $6.61 | $47.86 |
Univera Setting Professional Modifier None Typical Low $6.61 Median $15.85 Typical High $19.50 | Professional | None | $6.61 | $15.85 | $19.50 |
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 $6.17 Median $6.17 Typical High $7.08 | Professional | 52 · Reduced service | $6.17 | $6.17 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.82 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.82 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 90 · Outside lab | $7.59 | $7.59 | $7.59 |
Where New York sits
The same service costs 7.9 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· 40th of 51
$14.45
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.