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 $13.80 Median $15.85 Typical High $47.86 | Facility | None | $13.80 | $15.85 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $22.39 | Professional | None | $13.80 | $13.80 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $48.98 | Facility | None | $18.62 | $18.62 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $14.45 Typical High $48.98 | Professional | None | $9.33 | $14.45 | $48.98 |
CDPHP Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $40.74 Typical High $204.17 | Facility | None | $18.20 | $40.74 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $25.70 Typical High $125.89 | Professional | None | $12.88 | $25.70 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $14.45 Median $22.39 Typical High $42.66 | Facility | None | $14.45 | $22.39 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $8.91 Median $13.18 Typical High $36.31 | Professional | None | $8.91 | $13.18 | $36.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.13 Median $18.20 Typical High $20.89 | Professional | None | $14.13 | $18.20 | $20.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $14.79 Median $35.48 Typical High $87.10 | Facility | None | $14.79 | $35.48 | $87.10 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $33.88 Typical High $257.04 | Facility | None | $13.80 | $33.88 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $38.90 | Professional | None | $15.14 | $15.14 | $38.90 |
United Setting Facility Modifier None Typical Low $16.98 Median $18.62 Typical High $23.44 | Facility | None | $16.98 | $18.62 | $23.44 |
United Setting Professional Modifier None Typical Low $7.94 Median $11.75 Typical High $28.18 | Professional | None | $7.94 | $11.75 | $28.18 |
Univera Setting Facility Modifier None Typical Low $12.30 Median $17.38 Typical High $40.74 | Facility | None | $12.30 | $17.38 | $40.74 |
Univera Setting Professional Modifier None Typical Low $12.30 Median $18.20 Typical High $21.88 | Professional | None | $12.30 | $18.20 | $21.88 |
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 $6.92 Median $6.92 Typical High $7.94 | Professional | 52 · Reduced service | $6.92 | $6.92 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $3.16 | Professional | 53 · Discontinued | $2.82 | $2.82 | $3.16 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 90 · Outside lab | $8.71 | $8.71 | $8.71 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 90 · Outside lab | $12.59 | $12.59 | $12.59 |
Where New York sits
The same service costs 10.0 times more in Vermont 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· 36th of 51
$17.38
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.