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 $6.92 Median $8.13 Typical High $23.44 | Facility | None | $6.92 | $8.13 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.32 | Professional | None | $6.92 | $6.92 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $23.99 | Facility | None | $9.12 | $9.12 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $7.41 Typical High $25.12 | Professional | None | $4.57 | $7.41 | $25.12 |
CDPHP Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $8.91 Median $20.42 Typical High $100.00 | Facility | None | $8.91 | $20.42 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $12.59 Typical High $60.26 | Professional | None | $6.46 | $12.59 | $60.26 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $10.96 Typical High $20.89 | Facility | None | $7.08 | $10.96 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $4.37 Median $5.50 Typical High $17.78 | Professional | None | $4.37 | $5.50 | $17.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.03 Median $9.12 Typical High $12.30 | Professional | None | $6.03 | $9.12 | $12.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.31 Median $10.23 Typical High $19.05 | Facility | None | $6.31 | $10.23 | $19.05 |
MVP Health Care Setting Facility Modifier None Typical Low $11.48 Median $17.38 Typical High $257.04 | Facility | None | $11.48 | $17.38 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $19.05 | Professional | None | $7.41 | $7.41 | $19.05 |
United Setting Facility Modifier None Typical Low $8.32 Median $9.12 Typical High $30.20 | Facility | None | $8.32 | $9.12 | $30.20 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.50 Typical High $13.80 | Professional | None | $3.89 | $5.50 | $13.80 |
Univera Setting Facility Modifier None Typical Low $6.03 Median $10.72 Typical High $35.48 | Facility | None | $6.03 | $10.72 | $35.48 |
Univera Setting Professional Modifier None Typical Low $6.03 Median $9.12 Typical High $12.30 | Professional | None | $6.03 | $9.12 | $12.30 |
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 $3.47 Median $3.47 Typical High $3.89 | Professional | 52 · Reduced service | $3.47 | $3.47 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.38 Typical High $1.58 | Professional | 53 · Discontinued | $1.38 | $1.38 | $1.58 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 90 · Outside lab | $4.17 | $4.17 | $4.17 |
Where New York sits
The same service costs 3.6 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· 34th of 51
$8.32
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.