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 $16.22 Median $18.62 Typical High $54.95 | Facility | None | $16.22 | $18.62 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.98 Typical High $30.20 | Professional | None | $16.22 | $16.98 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $10.96 | Professional | None | $9.77 | $9.77 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $56.23 | Facility | None | $21.88 | $21.88 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $17.38 Typical High $58.88 | Professional | None | $10.72 | $17.38 | $58.88 |
CDPHP Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $47.86 Typical High $234.42 | Facility | None | $21.38 | $47.86 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $29.51 Typical High $128.82 | Professional | None | $15.14 | $29.51 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $11.48 Median $21.88 Typical High $48.98 | Facility | None | $11.48 | $21.88 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $10.23 Median $13.18 Typical High $41.69 | Professional | None | $10.23 | $13.18 | $41.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $33.11 | Professional | None | $14.13 | $21.88 | $33.11 |
Highmark BCBS Setting Facility Modifier None Typical Low $16.22 Median $40.74 Typical High $102.33 | Facility | None | $16.22 | $40.74 | $102.33 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $38.90 Typical High $257.04 | Facility | None | $13.80 | $38.90 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $45.71 | Professional | None | $17.38 | $17.38 | $45.71 |
United Setting Facility Modifier None Typical Low $19.50 Median $21.88 Typical High $26.92 | Facility | None | $19.50 | $21.88 | $26.92 |
United Setting Professional Modifier None Typical Low $9.12 Median $13.18 Typical High $32.36 | Professional | None | $9.12 | $13.18 | $32.36 |
Univera Setting Facility Modifier None Typical Low $14.13 Median $25.12 Typical High $83.18 | Facility | None | $14.13 | $25.12 | $83.18 |
Univera Setting Professional Modifier None Typical Low $14.13 Median $21.88 Typical High $33.11 | Professional | None | $14.13 | $21.88 | $33.11 |
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 $8.13 Median $8.13 Typical High $9.33 | Professional | 52 · Reduced service | $8.13 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.72 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.72 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $13.18 Median $14.45 Typical High $16.22 | Professional | 90 · Outside lab | $13.18 | $14.45 | $16.22 |
Where New York sits
The same service costs 4.8 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· 35th of 51
$19.95
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.