How much rates vary
Facilitymedian $28 · 10th to 90th $20 to $93Professionalmedian $23 · 10th to 90th $13 to $59
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 $19.05 Median $21.88 Typical High $64.57 | Facility | None | $19.05 | $21.88 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $37.15 | Professional | None | $19.05 | $21.88 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $67.61 | Facility | None | $25.70 | $25.70 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $20.42 Typical High $70.79 | Professional | None | $12.88 | $20.42 | $70.79 |
CDPHP Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $56.23 Typical High $281.84 | Facility | None | $25.12 | $56.23 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $34.67 Typical High $138.04 | Professional | None | $18.20 | $34.67 | $138.04 |
Emblem Health Setting Facility Modifier None Typical Low $20.89 Median $32.36 Typical High $57.54 | Facility | None | $20.89 | $32.36 | $57.54 |
Emblem Health Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $50.12 | Professional | None | $12.02 | $18.20 | $50.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $33.88 | Professional | None | $21.88 | $25.70 | $33.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $17.78 Median $40.74 Typical High $138.04 | Facility | None | $17.78 | $40.74 | $138.04 |
Highmark BCBS Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | None | $16.98 | $16.98 | $18.20 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $46.77 Typical High $257.04 | Facility | None | $13.80 | $46.77 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $53.70 | Professional | None | $20.89 | $20.89 | $53.70 |
United Setting Facility Modifier None Typical Low $23.44 Median $25.70 Typical High $104.71 | Facility | None | $23.44 | $25.70 | $104.71 |
United Setting Professional Modifier None Typical Low $10.96 Median $15.49 Typical High $38.90 | Professional | None | $10.96 | $15.49 | $38.90 |
Univera Setting Facility Modifier None Typical Low $16.98 Median $25.70 Typical High $66.07 | Facility | None | $16.98 | $25.70 | $66.07 |
Univera Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $33.88 | Professional | None | $16.98 | $25.70 | $33.88 |
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 $9.55 Median $9.55 Typical High $10.96 | Professional | 52 · Reduced service | $9.55 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $4.37 | Professional | 53 · Discontinued | $3.80 | $3.80 | $4.37 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 90 · Outside lab | $11.48 | $11.48 | $11.48 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 90 · Outside lab | $12.88 | $12.88 | $12.88 |
Where New York sits
The same service costs 7.4 times more in Vermont than in Alabama. 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
$25.70
VT $138AL $18.62
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.