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 $7.94 Typical High $23.44 | Facility | None | $6.92 | $7.94 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $10.96 | Professional | None | $6.92 | $7.59 | $10.96 |
Ambetter Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | None | $4.17 | $4.17 | $4.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $23.99 | Facility | None | $9.33 | $9.33 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.57 Median $7.41 Typical High $24.55 | Professional | None | $4.57 | $7.41 | $24.55 |
CDPHP Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $20.42 Typical High $100.00 | Facility | None | $9.12 | $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 $5.01 Median $10.72 Typical High $20.89 | Facility | None | $5.01 | $10.72 | $20.89 |
Emblem Health Setting Professional Modifier None Typical Low $4.37 Median $6.46 Typical High $18.20 | Professional | None | $4.37 | $6.46 | $18.20 |
Excellus BCBS Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.94 Median $9.33 Typical High $12.30 | Professional | None | $7.94 | $9.33 | $12.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.92 Median $16.60 Typical High $45.71 | Facility | None | $6.92 | $16.60 | $45.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
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 $4.37 Median $4.37 Typical High $19.05 | Professional | None | $4.37 | $4.37 | $19.05 |
United Setting Facility Modifier None Typical Low $8.32 Median $9.33 Typical High $12.02 | Facility | None | $8.32 | $9.33 | $12.02 |
United Setting Professional Modifier None Typical Low $3.89 Median $6.03 Typical High $14.13 | Professional | None | $3.89 | $6.03 | $14.13 |
Univera Setting Facility Modifier None Typical Low $6.17 Median $9.33 Typical High $23.44 | Facility | None | $6.17 | $9.33 | $23.44 |
Univera Setting Professional Modifier None Typical Low $6.17 Median $9.33 Typical High $12.30 | Professional | None | $6.17 | $9.33 | $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 $3.98 | Professional | 52 · Reduced service | $3.47 | $3.47 | $3.98 |
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 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 59 · Distinct service | $4.68 | $4.68 | $4.68 |
Where New York sits
The same service costs 12.9 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· 35th of 51
$8.91
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.