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 $5.62 Median $9.12 Typical High $26.92 | Facility | None | $5.62 | $9.12 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $12.02 | Professional | None | $5.62 | $5.75 | $12.02 |
Ambetter Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $28.18 | Facility | None | $10.72 | $10.72 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $7.76 Typical High $24.55 | Professional | None | $5.25 | $7.76 | $24.55 |
CDPHP Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $10.47 Median $23.44 Typical High $81.28 | Facility | None | $10.47 | $23.44 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $14.45 Typical High $72.44 | Professional | None | $7.59 | $14.45 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $8.13 Median $12.88 Typical High $23.99 | Facility | None | $8.13 | $12.88 | $23.99 |
Emblem Health Setting Professional Modifier None Typical Low $5.01 Median $7.59 Typical High $20.89 | Professional | None | $5.01 | $7.59 | $20.89 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.13 Median $10.23 Typical High $11.75 | Professional | None | $8.13 | $10.23 | $11.75 |
Highmark BCBS Setting Facility Modifier None Typical Low $9.12 Median $26.92 Typical High $48.98 | Facility | None | $9.12 | $26.92 | $48.98 |
MVP Health Care Setting Facility Modifier None Typical Low $10.72 Median $19.50 Typical High $257.04 | Facility | None | $10.72 | $19.50 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $21.88 | Professional | None | $8.71 | $8.71 | $21.88 |
United Setting Facility Modifier None Typical Low $9.77 Median $10.72 Typical High $30.20 | Facility | None | $9.77 | $10.72 | $30.20 |
United Setting Professional Modifier None Typical Low $4.47 Median $6.46 Typical High $16.22 | Professional | None | $4.47 | $6.46 | $16.22 |
Univera Setting Facility Modifier None Typical Low $7.08 Median $8.13 Typical High $30.20 | Facility | None | $7.08 | $8.13 | $30.20 |
Univera Setting Professional Modifier None Typical Low $7.08 Median $10.23 Typical High $12.02 | Professional | None | $7.08 | $10.23 | $12.02 |
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 $2.82 Median $2.82 Typical High $4.57 | Professional | 52 · Reduced service | $2.82 | $2.82 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.82 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.82 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $6.46 Median $7.08 Typical High $7.59 | Professional | 90 · Outside lab | $6.46 | $7.08 | $7.59 |
Where New York sits
The same service costs 13.8 times more in Vermont than in Utah. 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· 39th of 51
$9.12
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.