How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $17Professionalmedian $4 · 10th to 90th $2 to $10
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 $3.39 Median $3.80 Typical High $11.48 | Facility | None | $3.39 | $3.80 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $3.80 Typical High $7.94 | Professional | None | $3.39 | $3.80 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.24 | Professional | None | $2.04 | $2.04 | $2.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $11.75 | Facility | None | $4.47 | $4.47 | $11.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.24 Median $3.55 Typical High $12.30 | Professional | None | $2.24 | $3.55 | $12.30 |
CDPHP Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
Cigna Setting Facility Modifier None Typical Low $4.37 Median $10.23 Typical High $48.98 | Facility | None | $4.37 | $10.23 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $6.17 Typical High $32.36 | Professional | None | $3.09 | $6.17 | $32.36 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $5.37 Typical High $10.23 | Facility | None | $3.47 | $5.37 | $10.23 |
Emblem Health Setting Professional Modifier None Typical Low $2.14 Median $3.16 Typical High $8.71 | Professional | None | $2.14 | $3.16 | $8.71 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.80 Median $4.47 Typical High $5.37 | Professional | None | $3.80 | $4.47 | $5.37 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.55 Median $9.33 Typical High $30.90 | Facility | None | $3.55 | $9.33 | $30.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.95 Typical High $3.02 | Professional | None | $2.69 | $2.95 | $3.02 |
MVP Health Care Setting Facility Modifier None Typical Low $5.62 Median $9.77 Typical High $257.04 | Facility | None | $5.62 | $9.77 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $9.33 | Professional | None | $3.63 | $3.63 | $9.33 |
United Setting Facility Modifier None Typical Low $4.07 Median $4.47 Typical High $10.47 | Facility | None | $4.07 | $4.47 | $10.47 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.75 Typical High $6.92 | Professional | None | $1.91 | $2.75 | $6.92 |
Univera Setting Facility Modifier None Typical Low $2.95 Median $4.47 Typical High $11.48 | Facility | None | $2.95 | $4.47 | $11.48 |
Univera Setting Professional Modifier None Typical Low $2.95 Median $4.47 Typical High $5.89 | Professional | None | $2.95 | $4.47 | $5.89 |
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 $1.70 Median $1.70 Typical High $1.91 | Professional | 52 · Reduced service | $1.70 | $1.70 | $1.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.78 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.78 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $4.47 Median $6.76 Typical High $10.23 | Facility | QW · Waived lab test | $4.47 | $6.76 | $10.23 |
Fidelis Setting Professional Modifier QW · Waived lab test Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | QW · Waived lab test | $1.82 | $1.82 | $1.82 |
United Setting Professional Modifier QW · Waived lab test Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | QW · Waived lab test | $2.75 | $2.75 | $2.75 |
Where New York sits
The same service costs 15.8 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· 32nd of 51
$4.47
VT $54.95MD $3.47
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.