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 $5.25 Median $6.92 Typical High $25.12 | Facility | None | $5.25 | $6.92 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $8.13 | Professional | None | $5.25 | $5.25 | $8.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $20.89 | Facility | None | $8.13 | $8.13 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $5.89 Typical High $19.05 | Professional | None | $3.47 | $5.89 | $19.05 |
CDPHP Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $17.38 Typical High $75.86 | Facility | None | $7.94 | $17.38 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $9.55 Typical High $47.86 | Professional | None | $5.25 | $9.55 | $47.86 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $8.13 Typical High $18.20 | Facility | None | $3.47 | $8.13 | $18.20 |
Emblem Health Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $15.85 | Professional | None | $3.80 | $4.90 | $15.85 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.37 Median $7.76 Typical High $8.91 | Professional | None | $5.37 | $7.76 | $8.91 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.37 Median $14.45 Typical High $275.42 | Facility | None | $5.37 | $14.45 | $275.42 |
Highmark BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
MVP Health Care Setting Facility Modifier None Typical Low $8.71 Median $15.14 Typical High $257.04 | Facility | None | $8.71 | $15.14 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $16.60 | Professional | None | $5.62 | $5.62 | $16.60 |
United Setting Facility Modifier None Typical Low $7.24 Median $8.13 Typical High $10.23 | Facility | None | $7.24 | $8.13 | $10.23 |
United Setting Professional Modifier None Typical Low $3.39 Median $4.90 Typical High $12.02 | Professional | None | $3.39 | $4.90 | $12.02 |
Univera Setting Facility Modifier None Typical Low $5.37 Median $9.33 Typical High $26.92 | Facility | None | $5.37 | $9.33 | $26.92 |
Univera Setting Professional Modifier None Typical Low $5.37 Median $7.94 Typical High $9.33 | Professional | None | $5.37 | $7.94 | $9.33 |
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 $2.57 Median $2.57 Typical High $3.47 | Professional | 52 · Reduced service | $2.57 | $2.57 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.05 Median $1.05 Typical High $1.38 | Professional | 53 · Discontinued | $1.05 | $1.05 | $1.38 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 90 · Outside lab | $5.01 | $5.01 | $5.01 |
Where New York sits
The same service costs 8.3 times more in Kansas than in New Jersey. 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
$6.92
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.