How much rates vary
Facilitymedian $19 · 10th to 90th $9 to $60Professionalmedian $14 · 10th to 90th $8 to $38
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 $12.59 Median $14.13 Typical High $42.66 | Facility | None | $12.59 | $14.13 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $29.51 | Professional | None | $12.59 | $14.13 | $29.51 |
Ambetter Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | None | $7.59 | $7.59 | $8.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $43.65 | Facility | None | $16.98 | $16.98 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.32 Median $13.49 Typical High $44.67 | Professional | None | $8.32 | $13.49 | $44.67 |
CDPHP Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $37.15 Typical High $181.97 | Facility | None | $16.22 | $37.15 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $22.91 Typical High $109.65 | Professional | None | $13.49 | $22.91 | $109.65 |
Emblem Health Setting Facility Modifier None Typical Low $11.22 Median $20.42 Typical High $38.02 | Facility | None | $11.22 | $20.42 | $38.02 |
Emblem Health Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $36.31 | Professional | None | $8.32 | $11.75 | $36.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.12 Median $15.85 Typical High $19.05 | Professional | None | $9.12 | $15.85 | $19.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $14.13 Median $30.90 Typical High $87.10 | Facility | None | $14.13 | $30.90 | $87.10 |
Highmark BCBS Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $21.88 Typical High $257.04 | Facility | None | $13.80 | $21.88 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $34.67 | Professional | None | $13.49 | $13.49 | $34.67 |
United Setting Facility Modifier None Typical Low $5.89 Median $16.98 Typical High $60.26 | Facility | None | $5.89 | $16.98 | $60.26 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $25.70 | Professional | None | $7.08 | $10.00 | $25.70 |
Univera Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $42.66 | Facility | None | $9.12 | $9.12 | $42.66 |
Univera Setting Professional Modifier None Typical Low $9.12 Median $15.85 Typical High $19.95 | Professional | None | $9.12 | $15.85 | $19.95 |
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 $6.31 Median $6.31 Typical High $7.08 | Professional | 52 · Reduced service | $6.31 | $6.31 | $7.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.88 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.88 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $16.98 Median $25.12 Typical High $38.02 | Facility | QW · Waived lab test | $16.98 | $25.12 | $38.02 |
Fidelis Setting Professional Modifier QW · Waived lab test Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | QW · Waived lab test | $3.63 | $3.63 | $3.63 |
United Setting Professional Modifier QW · Waived lab test Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | QW · Waived lab test | $10.23 | $10.23 | $10.23 |
Where New York sits
The same service costs 7.8 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· 42nd of 51
$14.79
VT $105MD $13.49
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.