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 $3.80 Median $4.17 Typical High $12.02 | Facility | None | $3.80 | $4.17 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.37 | Professional | None | $3.63 | $3.63 | $4.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $12.59 | Facility | None | $4.90 | $4.90 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $3.89 Typical High $12.88 | Professional | None | $2.40 | $3.89 | $12.88 |
CDPHP Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $10.72 Typical High $52.48 | Facility | None | $4.79 | $10.72 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $7.24 Typical High $45.71 | Professional | None | $3.31 | $7.24 | $45.71 |
Emblem Health Setting Facility Modifier None Typical Low $3.98 Median $6.03 Typical High $10.96 | Facility | None | $3.98 | $6.03 | $10.96 |
Emblem Health Setting Professional Modifier None Typical Low $2.29 Median $3.39 Typical High $9.33 | Professional | None | $2.29 | $3.39 | $9.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $5.89 | Professional | None | $4.17 | $4.90 | $5.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
MVP Health Care Setting Facility Modifier None Typical Low $6.03 Median $10.47 Typical High $257.04 | Facility | None | $6.03 | $10.47 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.63 Median $3.89 Typical High $10.00 | Professional | None | $3.63 | $3.89 | $10.00 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.90 Typical High $6.03 | Facility | None | $4.37 | $4.90 | $6.03 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.95 Typical High $7.24 | Professional | None | $2.04 | $2.95 | $7.24 |
Univera Setting Facility Modifier None Typical Low $3.16 Median $4.90 Typical High $12.30 | Facility | None | $3.16 | $4.90 | $12.30 |
Univera Setting Professional Modifier None Typical Low $3.16 Median $4.90 Typical High $6.31 | Professional | None | $3.16 | $4.90 | $6.31 |
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 $1.82 Median $1.82 Typical High $2.04 | Professional | 52 · Reduced service | $1.82 | $1.82 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.72 Median $0.72 Typical High $0.83 | Professional | 53 · Discontinued | $0.72 | $0.72 | $0.83 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 90 · Outside lab | $3.24 | $3.24 | $3.24 |
Where New York sits
The same service costs 3.8 times more in Kansas than in Nebraska. 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· 31st of 51
$4.68
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.