How much rates vary
Facilitymedian $11 · 10th to 90th $8 to $34Professionalmedian $9 · 10th to 90th $5 to $23
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 $5.50 Median $9.77 Typical High $28.84 | Facility | None | $5.50 | $9.77 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $6.03 Typical High $10.72 | Professional | None | $5.50 | $6.03 | $10.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $29.51 | Facility | None | $11.48 | $11.48 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $7.76 Typical High $25.12 | Professional | None | $5.62 | $7.76 | $25.12 |
CDPHP Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $25.12 Typical High $79.43 | Facility | None | $11.22 | $25.12 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $15.49 Typical High $77.62 | Professional | None | $8.13 | $15.49 | $77.62 |
Emblem Health Setting Facility Modifier None Typical Low $8.51 Median $13.80 Typical High $25.70 | Facility | None | $8.51 | $13.80 | $25.70 |
Emblem Health Setting Professional Modifier None Typical Low $5.37 Median $7.94 Typical High $21.88 | Professional | None | $5.37 | $7.94 | $21.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.94 Median $10.23 Typical High $12.59 | Professional | None | $7.94 | $10.23 | $12.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $9.12 Median $23.99 Typical High $52.48 | Facility | None | $9.12 | $23.99 | $52.48 |
MVP Health Care Setting Facility Modifier None Typical Low $11.48 Median $19.95 Typical High $257.04 | Facility | None | $11.48 | $19.95 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $23.44 | Professional | None | $9.12 | $9.12 | $23.44 |
United Setting Facility Modifier None Typical Low $10.23 Median $11.48 Typical High $37.15 | Facility | None | $10.23 | $11.48 | $37.15 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.76 Typical High $16.98 | Professional | None | $4.79 | $6.76 | $16.98 |
Univera Setting Facility Modifier None Typical Low $7.41 Median $7.94 Typical High $25.12 | Facility | None | $7.41 | $7.94 | $25.12 |
Univera Setting Professional Modifier None Typical Low $7.41 Median $10.23 Typical High $12.88 | Professional | None | $7.41 | $10.23 | $12.88 |
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 $2.75 Median $2.75 Typical High $4.79 | Professional | 52 · Reduced service | $2.75 | $2.75 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.95 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.95 |
Ambetter Setting Professional Modifier 90 · Outside lab Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 90 · Outside lab | $5.13 | $5.13 | $5.13 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $3.16 Median $3.16 Typical High $3.98 | Professional | 90 · Outside lab | $3.16 | $3.16 | $3.98 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $7.59 Median $7.59 Typical High $8.51 | Professional | 90 · Outside lab | $7.59 | $7.59 | $8.51 |
Where New York sits
The same service costs 15.1 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· 40th of 51
$9.77
VT $129MD $8.51
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.