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 $2.51 Median $3.02 Typical High $9.12 | Facility | None | $2.51 | $3.02 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.02 Typical High $5.01 | Professional | None | $2.51 | $3.02 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $9.33 | Facility | None | $3.55 | $3.55 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.78 Median $3.55 Typical High $10.00 | Professional | None | $1.78 | $3.55 | $10.00 |
CDPHP Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $7.94 Typical High $36.31 | Facility | None | $3.47 | $7.94 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $4.90 Typical High $26.30 | Professional | None | $2.57 | $4.90 | $26.30 |
Emblem Health Setting Facility Modifier None Typical Low $2.51 Median $4.07 Typical High $8.13 | Facility | None | $2.51 | $4.07 | $8.13 |
Emblem Health Setting Professional Modifier None Typical Low $1.70 Median $2.51 Typical High $6.92 | Professional | None | $1.70 | $2.51 | $6.92 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.19 Median $3.39 Typical High $3.98 | Professional | None | $2.19 | $3.39 | $3.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.09 Median $4.37 Typical High $18.20 | Facility | None | $3.09 | $4.37 | $18.20 |
MVP Health Care Setting Facility Modifier None Typical Low $3.55 Median $13.80 Typical High $257.04 | Facility | None | $3.55 | $13.80 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $8.32 | Professional | None | $2.88 | $2.88 | $8.32 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.55 Typical High $4.47 | Facility | None | $3.24 | $3.55 | $4.47 |
United Setting Professional Modifier None Typical Low $1.62 Median $2.34 Typical High $5.37 | Professional | None | $1.62 | $2.34 | $5.37 |
Univera Setting Facility Modifier None Typical Low $2.34 Median $4.07 Typical High $8.51 | Facility | None | $2.34 | $4.07 | $8.51 |
Univera Setting Professional Modifier None Typical Low $2.14 Median $3.39 Typical High $3.98 | Professional | None | $2.14 | $3.39 | $3.98 |
5 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 $1.26 Median $1.26 Typical High $1.51 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.62 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.62 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $3.55 Median $5.37 Typical High $8.13 | Facility | QW · Waived lab test | $3.55 | $5.37 | $8.13 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab + QW · Waived lab test Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 90 · Outside lab + QW · Waived lab test | $2.40 | $2.40 | $2.40 |
United Setting Professional Modifier QW · Waived lab test Typical Low $1.38 Median $1.38 Typical High $2.04 | Professional | QW · Waived lab test | $1.38 | $1.38 | $2.04 |
Where New York sits
The same service costs 3.5 times more in Kansas than in Tennessee. 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· 38th of 51
$3.39
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.