How much rates vary
Facilitymedian $4 · 10th to 90th $3 to $15Professionalmedian $3 · 10th to 90th $2 to $9
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 $2.88 Median $3.31 Typical High $10.00 | Facility | None | $2.88 | $3.31 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $3.31 Typical High $5.89 | Professional | None | $2.88 | $3.31 | $5.89 |
Ambetter Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $10.23 | Facility | None | $3.89 | $3.89 | $10.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.95 Median $3.47 Typical High $10.47 | Professional | None | $1.95 | $3.47 | $10.47 |
CDPHP Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $9.77 Typical High $41.69 | Facility | None | $3.80 | $9.77 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $3.16 Median $5.37 Typical High $28.18 | Professional | None | $3.16 | $5.37 | $28.18 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $5.13 Typical High $8.91 | Facility | None | $3.47 | $5.13 | $8.91 |
Emblem Health Setting Professional Modifier None Typical Low $2.29 Median $4.47 Typical High $5.13 | Professional | None | $2.29 | $4.47 | $5.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.82 Median $3.89 Typical High $4.68 | Professional | None | $2.82 | $3.89 | $4.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.24 Median $7.76 Typical High $43.65 | Facility | None | $3.24 | $7.76 | $43.65 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
MVP Health Care Setting Facility Modifier None Typical Low $4.90 Median $8.51 Typical High $257.04 | Facility | None | $4.90 | $8.51 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $8.13 | Professional | None | $3.16 | $3.16 | $8.13 |
United Setting Facility Modifier None Typical Low $3.55 Median $3.89 Typical High $10.47 | Facility | None | $3.55 | $3.89 | $10.47 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.75 Typical High $5.89 | Professional | None | $1.78 | $2.75 | $5.89 |
Univera Setting Facility Modifier None Typical Low $2.57 Median $3.89 Typical High $10.00 | Facility | None | $2.57 | $3.89 | $10.00 |
Univera Setting Professional Modifier None Typical Low $2.57 Median $3.89 Typical High $5.13 | Professional | None | $2.57 | $3.89 | $5.13 |
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 $1.45 Median $1.45 Typical High $1.66 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.68 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.68 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $3.89 Median $5.89 Typical High $8.91 | Facility | QW · Waived lab test | $3.89 | $5.89 | $8.91 |
United Setting Professional Modifier QW · Waived lab test Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | QW · Waived lab test | $2.40 | $2.40 | $2.40 |
Where New York sits
The same service costs 12.6 times more in Vermont than in Washington, DC. 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· 44th of 51
$3.89
VT $39.81DC $3.16
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.