How much rates vary
Facilitymedian $13 · 10th to 90th $9 to $37Professionalmedian $10 · 10th to 90th $6 to $27
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 $8.91 Median $10.23 Typical High $30.20 | Facility | None | $8.91 | $10.23 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $9.33 Typical High $15.14 | Professional | None | $8.91 | $9.33 | $15.14 |
Ambetter Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $30.90 | Facility | None | $12.02 | $12.02 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $9.55 Typical High $33.11 | Professional | None | $5.89 | $9.55 | $33.11 |
CDPHP Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $28.84 Typical High $128.82 | Facility | None | $11.75 | $28.84 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $8.32 Median $16.22 Typical High $81.28 | Professional | None | $8.32 | $16.22 | $81.28 |
Emblem Health Setting Facility Modifier None Typical Low $7.59 Median $14.45 Typical High $26.92 | Facility | None | $7.59 | $14.45 | $26.92 |
Emblem Health Setting Professional Modifier None Typical Low $5.62 Median $8.32 Typical High $23.44 | Professional | None | $5.62 | $8.32 | $23.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $15.85 | Professional | None | $10.23 | $12.02 | $15.85 |
Highmark BCBS Setting Facility Modifier None Typical Low $8.71 Median $30.20 Typical High $83.18 | Facility | None | $8.71 | $30.20 | $83.18 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $21.38 Typical High $257.04 | Facility | None | $13.80 | $21.38 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $24.55 | Professional | None | $9.55 | $9.55 | $24.55 |
United Setting Facility Modifier None Typical Low $10.72 Median $12.02 Typical High $15.14 | Facility | None | $10.72 | $12.02 | $15.14 |
United Setting Professional Modifier None Typical Low $5.01 Median $7.24 Typical High $19.05 | Professional | None | $5.01 | $7.24 | $19.05 |
Univera Setting Facility Modifier None Typical Low $7.94 Median $10.72 Typical High $30.20 | Facility | None | $7.94 | $10.72 | $30.20 |
Univera Setting Professional Modifier None Typical Low $7.94 Median $12.02 Typical High $21.38 | Professional | None | $7.94 | $12.02 | $21.38 |
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 $4.47 Median $4.47 Typical High $5.13 | Professional | 52 · Reduced service | $4.47 | $4.47 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $1.78 Typical High $2.04 | Professional | 53 · Discontinued | $1.78 | $1.78 | $2.04 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 59 · Distinct service | $5.37 | $5.37 | $5.37 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service + 90 · Outside lab + 91 · Repeat lab test Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 59 · Distinct service + 90 · Outside lab + 91 · Repeat lab test | $7.94 | $7.94 | $7.94 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Illinois. 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· 39th of 51
$10.72
AK $33.11IL $9.33
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.