How much rates vary
Facilitymedian $7 · 10th to 90th $5 to $24Professionalmedian $5 · 10th to 90th $3 to $15
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 $4.79 Median $5.50 Typical High $16.22 | Facility | None | $4.79 | $5.50 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $5.50 Typical High $9.12 | Professional | None | $4.79 | $5.50 | $9.12 |
Ambetter Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $16.98 | Facility | None | $6.46 | $6.46 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $5.13 Typical High $16.98 | Professional | None | $3.24 | $5.13 | $16.98 |
CDPHP Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $14.13 Typical High $70.79 | Facility | None | $6.31 | $14.13 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $8.91 Typical High $43.65 | Professional | None | $5.13 | $8.91 | $43.65 |
Emblem Health Setting Facility Modifier None Typical Low $5.01 Median $7.76 Typical High $14.45 | Facility | None | $5.01 | $7.76 | $14.45 |
Emblem Health Setting Professional Modifier None Typical Low $3.02 Median $4.57 Typical High $12.59 | Professional | None | $3.02 | $4.57 | $12.59 |
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 $5.13 Median $6.46 Typical High $7.24 | Professional | None | $5.13 | $6.46 | $7.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.37 Median $16.98 Typical High $31.62 | Facility | None | $5.37 | $16.98 | $31.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $4.07 Median $4.27 Typical High $4.57 | Professional | None | $4.07 | $4.27 | $4.57 |
MVP Health Care Setting Facility Modifier None Typical Low $6.61 Median $12.88 Typical High $257.04 | Facility | None | $6.61 | $12.88 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $13.49 | Professional | None | $5.25 | $5.25 | $13.49 |
United Setting Facility Modifier None Typical Low $2.19 Median $6.46 Typical High $20.89 | Facility | None | $2.19 | $6.46 | $20.89 |
United Setting Professional Modifier None Typical Low $2.69 Median $4.17 Typical High $9.77 | Professional | None | $2.69 | $4.17 | $9.77 |
Univera Setting Facility Modifier None Typical Low $4.27 Median $5.13 Typical High $16.60 | Facility | None | $4.27 | $5.13 | $16.60 |
Univera Setting Professional Modifier None Typical Low $4.27 Median $6.46 Typical High $7.76 | Professional | None | $4.27 | $6.46 | $7.76 |
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 $2.40 Median $2.40 Typical High $2.75 | Professional | 52 · Reduced service | $2.40 | $2.40 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $1.10 | Professional | 53 · Discontinued | $0.95 | $0.95 | $1.10 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $6.46 Median $9.77 Typical High $14.45 | Facility | QW · Waived lab test | $6.46 | $9.77 | $14.45 |
United Setting Professional Modifier QW · Waived lab test Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | QW · Waived lab test | $3.98 | $3.98 | $3.98 |
Where New York sits
The same service costs 11.5 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
$5.75
VT $56.23MD $4.90
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.