How much rates vary
Facilitymedian $30 · 10th to 90th $21 to $100Professionalmedian $25 · 10th to 90th $14 to $63
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 $20.89 Median $23.99 Typical High $70.79 | Facility | None | $20.89 | $23.99 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $23.99 Typical High $48.98 | Professional | None | $20.89 | $23.99 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $72.44 | Facility | None | $28.18 | $28.18 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $77.62 | Professional | None | $13.80 | $22.39 | $77.62 |
CDPHP Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $61.66 Typical High $302.00 | Facility | None | $27.54 | $61.66 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $39.81 Typical High $186.21 | Professional | None | $19.50 | $39.81 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $19.50 Median $31.62 Typical High $63.10 | Facility | None | $19.50 | $31.62 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $16.60 Median $32.36 Typical High $52.48 | Professional | None | $16.60 | $32.36 | $52.48 |
Excellus BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $22.39 Median $28.18 Typical High $33.88 | Professional | None | $22.39 | $28.18 | $33.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $20.42 Median $50.12 Typical High $151.36 | Facility | None | $20.42 | $50.12 | $151.36 |
Highmark BCBS Setting Professional Modifier None Typical Low $16.60 Median $18.62 Typical High $19.95 | Professional | None | $16.60 | $18.62 | $19.95 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $50.12 Typical High $257.04 | Facility | None | $13.80 | $50.12 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $57.54 | Professional | None | $20.89 | $20.89 | $57.54 |
United Setting Facility Modifier None Typical Low $25.12 Median $28.18 Typical High $89.13 | Facility | None | $25.12 | $28.18 | $89.13 |
United Setting Professional Modifier None Typical Low $11.75 Median $18.20 Typical High $42.66 | Professional | None | $11.75 | $18.20 | $42.66 |
Univera Setting Facility Modifier None Typical Low $18.20 Median $28.18 Typical High $70.79 | Facility | None | $18.20 | $28.18 | $70.79 |
Univera Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $36.31 | Professional | None | $18.20 | $28.18 | $36.31 |
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 $10.47 Median $10.47 Typical High $11.75 | Professional | 52 · Reduced service | $10.47 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.79 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.79 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $11.22 Median $11.22 Typical High $19.95 | Professional | 90 · Outside lab | $11.22 | $11.22 | $19.95 |
Where New York sits
The same service costs 7.8 times more in Vermont than in Alabama. 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
$27.54
VT $145AL $18.62
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.