How much rates vary
Facilitymedian $8 · 10th to 90th $5 to $26Professionalmedian $6 · 10th to 90th $3 to $16
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 $5.37 Median $6.17 Typical High $18.20 | Facility | None | $5.37 | $6.17 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $6.17 Typical High $10.00 | Professional | None | $5.37 | $6.17 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.63 | Professional | None | $3.24 | $3.24 | $3.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $18.62 | Facility | None | $7.24 | $7.24 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $5.75 Typical High $19.05 | Professional | None | $3.55 | $5.75 | $19.05 |
CDPHP Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $15.85 Typical High $77.62 | Facility | None | $7.08 | $15.85 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $9.77 Typical High $47.86 | Professional | None | $5.01 | $9.77 | $47.86 |
Emblem Health Setting Facility Modifier None Typical Low $5.50 Median $8.71 Typical High $16.22 | Facility | None | $5.50 | $8.71 | $16.22 |
Emblem Health Setting Professional Modifier None Typical Low $3.39 Median $5.01 Typical High $14.13 | Professional | None | $3.39 | $5.01 | $14.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $8.13 | Professional | None | $4.79 | $6.92 | $8.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.25 Median $15.49 Typical High $61.66 | Facility | None | $5.25 | $15.49 | $61.66 |
Highmark BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.79 Typical High $5.37 | Professional | None | $4.37 | $4.79 | $5.37 |
MVP Health Care Setting Facility Modifier None Typical Low $7.24 Median $13.80 Typical High $257.04 | Facility | None | $7.24 | $13.80 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $14.79 | Professional | None | $2.19 | $2.19 | $14.79 |
United Setting Facility Modifier None Typical Low $6.46 Median $7.24 Typical High $8.91 | Facility | None | $6.46 | $7.24 | $8.91 |
United Setting Professional Modifier None Typical Low $3.02 Median $4.37 Typical High $10.72 | Professional | None | $3.02 | $4.37 | $10.72 |
Univera Setting Facility Modifier None Typical Low $4.68 Median $5.13 Typical High $18.20 | Facility | None | $4.68 | $5.13 | $18.20 |
Univera Setting Professional Modifier None Typical Low $4.68 Median $6.92 Typical High $8.51 | Professional | None | $4.68 | $6.92 | $8.51 |
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 $2.69 Median $2.69 Typical High $3.09 | Professional | 52 · Reduced service | $2.69 | $2.69 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.23 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.23 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $7.24 Median $10.72 Typical High $16.22 | Facility | QW · Waived lab test | $7.24 | $10.72 | $16.22 |
United Setting Professional Modifier QW · Waived lab test Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | QW · Waived lab test | $4.37 | $4.37 | $4.37 |
Where New York sits
The same service costs 5.8 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· 42nd of 51
$6.17
VT $30.90MD $5.37
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.