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 $10.47 Median $14.45 Typical High $42.66 | Facility | None | $10.47 | $14.45 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | None | $10.47 | $10.47 | $15.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $44.67 | Facility | None | $16.98 | $16.98 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $12.59 Typical High $40.74 | Professional | None | $7.24 | $12.59 | $40.74 |
CDPHP Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $38.02 Typical High $151.36 | Facility | None | $16.60 | $38.02 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $23.44 Typical High $112.20 | Professional | None | $12.02 | $23.44 | $112.20 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $16.98 Typical High $38.90 | Facility | None | $7.08 | $16.98 | $38.90 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $12.02 Typical High $33.11 | Professional | None | $8.13 | $12.02 | $33.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.03 Median $16.60 Typical High $19.05 | Professional | None | $6.03 | $16.60 | $19.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $14.79 Median $25.70 Typical High $79.43 | Facility | None | $14.79 | $25.70 | $79.43 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $28.18 Typical High $257.04 | Facility | None | $13.80 | $28.18 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $44.67 | Professional | None | $13.80 | $13.80 | $44.67 |
United Setting Facility Modifier None Typical Low $15.49 Median $16.98 Typical High $21.38 | Facility | None | $15.49 | $16.98 | $21.38 |
United Setting Professional Modifier None Typical Low $7.24 Median $10.23 Typical High $25.70 | Professional | None | $7.24 | $10.23 | $25.70 |
Univera Setting Facility Modifier None Typical Low $11.22 Median $13.18 Typical High $19.50 | Facility | None | $11.22 | $13.18 | $19.50 |
Univera Setting Professional Modifier None Typical Low $6.03 Median $16.22 Typical High $21.88 | Professional | None | $6.03 | $16.22 | $21.88 |
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 $5.25 Median $5.25 Typical High $7.24 | Professional | 52 · Reduced service | $5.25 | $5.25 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.88 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.88 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 90 · Outside lab | $6.61 | $6.61 | $6.61 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 90 · Outside lab | $11.48 | $11.48 | $11.48 |
Where New York sits
The same service costs 4.2 times more in Kansas 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· 41st of 51
$13.80
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.