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 $2.34 Median $4.27 Typical High $12.59 | Facility | None | $2.34 | $4.27 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $2.34 Median $4.17 Typical High $8.91 | Professional | None | $2.34 | $4.17 | $8.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $13.18 | Facility | None | $5.01 | $5.01 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $4.37 Typical High $10.72 | Professional | None | $2.04 | $4.37 | $10.72 |
CDPHP Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $12.59 Typical High $44.67 | Facility | None | $4.90 | $12.59 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $5.75 Typical High $24.55 | Professional | None | $2.57 | $5.75 | $24.55 |
Emblem Health Setting Facility Modifier None Typical Low $1.51 Median $5.01 Typical High $11.22 | Facility | None | $1.51 | $5.01 | $11.22 |
Emblem Health Setting Professional Modifier None Typical Low $2.75 Median $3.63 Typical High $5.01 | Professional | None | $2.75 | $3.63 | $5.01 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Facility | None | $2.04 | $2.04 | $2.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.04 Median $3.31 Typical High $5.50 | Professional | None | $2.04 | $3.31 | $5.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.39 Median $6.31 Typical High $91.20 | Facility | None | $3.39 | $6.31 | $91.20 |
MVP Health Care Setting Facility Modifier None Typical Low $3.98 Median $10.00 Typical High $257.04 | Facility | None | $3.98 | $10.00 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $10.47 | Professional | None | $3.31 | $3.31 | $10.47 |
United Setting Facility Modifier None Typical Low $4.57 Median $5.01 Typical High $8.32 | Facility | None | $4.57 | $5.01 | $8.32 |
United Setting Professional Modifier None Typical Low $2.29 Median $3.02 Typical High $6.92 | Professional | None | $2.29 | $3.02 | $6.92 |
Univera Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $8.13 | Facility | None | $2.04 | $2.04 | $8.13 |
Univera Setting Professional Modifier None Typical Low $2.04 Median $3.31 Typical High $5.62 | Professional | None | $2.04 | $3.31 | $5.62 |
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 $1.17 Median $1.17 Typical High $2.14 | Professional | 52 · Reduced service | $1.17 | $1.17 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.47 Median $0.47 Typical High $0.85 | Professional | 53 · Discontinued | $0.47 | $0.47 | $0.85 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service + GC · Resident with teaching physician + QW · Waived lab test Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 59 · Distinct service + GC · Resident with teaching physician + QW · Waived lab test | $3.39 | $3.39 | $3.39 |
Where New York sits
The same service costs 3.0 times more in Alaska than in Kentucky. 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· 43rd of 51
$4.07
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.