How much rates vary
Facilitymedian $21 · 10th to 90th $12 to $100Professionalmedian $23 · 10th to 90th $7 to $87
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 $16.60 Median $16.60 Typical High $22.91 | Facility | None | $16.60 | $16.60 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.60 Typical High $218.78 | Professional | None | $16.22 | $16.60 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $35.48 Typical High $38.02 | Facility | None | $29.51 | $35.48 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.76 Median $27.54 Typical High $100.00 | Professional | None | $6.76 | $27.54 | $100.00 |
CareSource Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
CareSource 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 $33.88 Median $39.81 Typical High $52.48 | Facility | None | $33.88 | $39.81 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $23.44 Typical High $42.66 | Professional | None | $8.91 | $23.44 | $42.66 |
DeanCare Setting Facility Modifier None Typical Low $12.30 Median $67.61 Typical High $104.71 | Facility | None | $12.30 | $67.61 | $104.71 |
Medica Setting Facility Modifier None Typical Low $11.22 Median $27.54 Typical High $151.36 | Facility | None | $11.22 | $27.54 | $151.36 |
Medica Setting Professional Modifier None Typical Low $7.94 Median $13.80 Typical High $44.67 | Professional | None | $7.94 | $13.80 | $44.67 |
Network Health Setting Facility Modifier None Typical Low $16.60 Median $20.89 Typical High $38.90 | Facility | None | $16.60 | $20.89 | $38.90 |
Network Health Setting Professional Modifier None Typical Low $10.23 Median $13.80 Typical High $38.90 | Professional | None | $10.23 | $13.80 | $38.90 |
Prevea360 Setting Facility Modifier None Typical Low $10.96 Median $12.30 Typical High $17.38 | Facility | None | $10.96 | $12.30 | $17.38 |
Quartz Setting Professional Modifier None Typical Low $15.14 Median $32.36 Typical High $57.54 | Professional | None | $15.14 | $32.36 | $57.54 |
Quartz Setting Professional Modifier None Typical Low $6.46 Median $8.91 Typical High $35.48 | Professional | None | $6.46 | $8.91 | $35.48 |
Security Health Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $28.84 | Professional | None | $24.55 | $24.55 | $28.84 |
Security Health Setting Professional Modifier None Typical Low $24.55 Median $69.18 Typical High $95.50 | Professional | None | $24.55 | $69.18 | $95.50 |
United Setting Facility Modifier None Typical Low $4.79 Median $16.60 Typical High $36.31 | Facility | None | $4.79 | $16.60 | $36.31 |
United Setting Professional Modifier None Typical Low $6.92 Median $11.48 Typical High $52.48 | Professional | None | $6.92 | $11.48 | $52.48 |
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 $8.13 Median $8.13 Typical High $109.65 | Professional | 52 · Reduced service | $8.13 | $8.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.31 Typical High $43.65 | Professional | 53 · Discontinued | $3.31 | $3.31 | $43.65 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $9.33 Median $13.80 Typical High $19.95 | Professional | QW · Waived lab test | $9.33 | $13.80 | $19.95 |
Where Wisconsin 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.
Wisconsin· 9th of 51
$22.91
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.