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 $10.72 Median $14.45 Typical High $42.66 | Facility | None | $10.72 | $14.45 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $15.49 | Professional | None | $10.72 | $10.72 | $15.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $43.65 | Facility | None | $16.98 | $16.98 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $40.74 | Professional | None | $8.32 | $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 $37.15 Typical High $154.88 | Facility | None | $16.60 | $37.15 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $22.91 Typical High $109.65 | Professional | None | $11.75 | $22.91 | $109.65 |
Emblem Health Setting Facility Modifier None Typical Low $11.48 Median $18.62 Typical High $38.02 | Facility | None | $11.48 | $18.62 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $32.36 | Professional | None | $7.94 | $10.72 | $32.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.72 Median $15.14 Typical High $18.62 | Professional | None | $10.72 | $15.14 | $18.62 |
Highmark BCBS Setting Facility Modifier None Typical Low $13.49 Median $33.88 Typical High $66.07 | Facility | None | $13.49 | $33.88 | $66.07 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $22.91 Typical High $257.04 | Facility | None | $13.80 | $22.91 | $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 $16.98 Typical High $20.89 | Facility | None | $15.14 | $16.98 | $20.89 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $25.12 | Professional | None | $7.08 | $10.00 | $25.12 |
Univera Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $26.92 | Facility | None | $10.72 | $10.72 | $26.92 |
Univera Setting Professional Modifier None Typical Low $10.72 Median $15.14 Typical High $19.05 | Professional | None | $10.72 | $15.14 | $19.05 |
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 $5.37 Median $5.37 Typical High $7.24 | Professional | 52 · Reduced service | $5.37 | $5.37 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.88 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.88 |
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 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $10.00 Median $11.22 Typical High $11.22 | Professional | 90 · Outside lab | $10.00 | $11.22 | $11.22 |
Where New York sits
The same service costs 13.8 times more in Kansas than in Kentucky. 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· 42nd of 51
$13.49
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.