How much rates vary
Facilitymedian $14 · 10th to 90th $5 to $48Professionalmedian $10 · 10th to 90th $6 to $27
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 $5.25 Median $11.75 Typical High $34.67 | Facility | None | $5.25 | $11.75 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $7.76 Typical High $16.22 | Professional | None | $5.25 | $7.76 | $16.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $35.48 | Facility | None | $13.80 | $13.80 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $9.55 Typical High $28.18 | Professional | None | $6.76 | $9.55 | $28.18 |
CDPHP Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $30.20 Typical High $75.86 | Facility | None | $13.49 | $30.20 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $18.62 Typical High $91.20 | Professional | None | $9.55 | $18.62 | $91.20 |
Emblem Health Setting Facility Modifier None Typical Low $12.02 Median $17.78 Typical High $30.90 | Facility | None | $12.02 | $17.78 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $26.30 | Professional | None | $6.46 | $8.13 | $26.30 |
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 $13.80 Typical High $15.49 | Professional | None | $5.13 | $13.80 | $15.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $11.22 Median $30.90 Typical High $125.89 | Facility | None | $11.22 | $30.90 | $125.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
MVP Health Care Setting Facility Modifier None Typical Low $10.96 Median $19.95 Typical High $257.04 | Facility | None | $10.96 | $19.95 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $28.18 | Professional | None | $10.47 | $10.47 | $28.18 |
United Setting Facility Modifier None Typical Low $4.79 Median $13.80 Typical High $36.31 | Facility | None | $4.79 | $13.80 | $36.31 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.61 Typical High $20.42 | Professional | None | $5.75 | $6.61 | $20.42 |
Univera Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $34.67 | Facility | None | $5.13 | $5.13 | $34.67 |
Univera Setting Professional Modifier None Typical Low $5.13 Median $13.80 Typical High $16.22 | Professional | None | $5.13 | $13.80 | $16.22 |
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 $2.57 Median $2.57 Typical High $5.75 | Professional | 52 · Reduced service | $2.57 | $2.57 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $2.34 | Professional | 53 · Discontinued | $1.05 | $1.05 | $2.34 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $13.80 Median $20.42 Typical High $30.90 | Facility | QW · Waived lab test | $13.80 | $20.42 | $30.90 |
United Setting Professional Modifier QW · Waived lab test Typical Low $4.27 Median $8.32 Typical High $8.32 | Professional | QW · Waived lab test | $4.27 | $8.32 | $8.32 |
Where New York sits
The same service costs 9.5 times more in Vermont than in Rhode Island. 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
$11.75
VT $97.72RI $10.23
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.