How much rates vary
Facilitymedian $5 · 10th to 90th $4 to $17Professionalmedian $4 · 10th to 90th $2 to $11
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 $3.55 Median $4.07 Typical High $12.02 | Facility | None | $3.55 | $4.07 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.72 Typical High $7.08 | Professional | None | $3.55 | $3.72 | $7.08 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $12.30 | Facility | None | $4.79 | $4.79 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.34 Median $3.80 Typical High $12.30 | Professional | None | $2.34 | $3.80 | $12.30 |
CDPHP Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $10.47 Typical High $51.29 | Facility | None | $4.68 | $10.47 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $6.76 Typical High $32.36 | Professional | None | $3.80 | $6.76 | $32.36 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $5.62 Typical High $10.72 | Facility | None | $3.47 | $5.62 | $10.72 |
Emblem Health Setting Professional Modifier None Typical Low $2.24 Median $3.31 Typical High $9.12 | Professional | None | $2.24 | $3.31 | $9.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.89 Median $4.79 Typical High $5.75 | Professional | None | $3.89 | $4.79 | $5.75 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.80 Median $11.75 Typical High $45.71 | Facility | None | $3.80 | $11.75 | $45.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
MVP Health Care Setting Facility Modifier None Typical Low $5.50 Median $10.23 Typical High $257.04 | Facility | None | $5.50 | $10.23 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $9.77 | Professional | None | $2.45 | $2.45 | $9.77 |
United Setting Facility Modifier None Typical Low $4.27 Median $4.79 Typical High $5.89 | Facility | None | $4.27 | $4.79 | $5.89 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.82 Typical High $7.08 | Professional | None | $2.14 | $2.82 | $7.08 |
Univera Setting Facility Modifier None Typical Low $3.09 Median $4.79 Typical High $11.22 | Facility | None | $3.09 | $4.79 | $11.22 |
Univera Setting Professional Modifier None Typical Low $3.09 Median $4.79 Typical High $6.17 | Professional | None | $3.09 | $4.79 | $6.17 |
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 $1.78 Median $1.78 Typical High $2.04 | Professional | 52 · Reduced service | $1.78 | $1.78 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.81 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.81 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $4.79 Median $7.08 Typical High $10.72 | Facility | QW · Waived lab test | $4.79 | $7.08 | $10.72 |
United Setting Professional Modifier QW · Waived lab test Typical Low $2.69 Median $2.69 Typical High $2.88 | Professional | QW · Waived lab test | $2.69 | $2.69 | $2.88 |
Where New York sits
The same service costs 12.9 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· 41st of 51
$4.57
VT $48.98DC $3.80
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.