How much rates vary
Facilitymedian $12 · 10th to 90th $5 to $36Professionalmedian $11 · 10th to 90th $6 to $32
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 $14.13 | Professional | None | $8.91 | $9.33 | $14.13 |
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 $31.62 | Facility | None | $12.02 | $12.02 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $12.02 Typical High $38.02 | Professional | None | $5.89 | $12.02 | $38.02 |
CDPHP Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $25.70 | Professional | None | $12.02 | $12.02 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $11.75 Median $31.62 Typical High $131.83 | Facility | None | $11.75 | $31.62 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $26.92 Typical High $95.50 | Professional | None | $16.22 | $26.92 | $95.50 |
Emblem Health Setting Facility Modifier None Typical Low $8.13 Median $13.18 Typical High $26.92 | Facility | None | $8.13 | $13.18 | $26.92 |
Emblem Health Setting Professional Modifier None Typical Low $5.62 Median $7.24 Typical High $23.44 | Professional | None | $5.62 | $7.24 | $23.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Facility | None | $5.25 | $5.25 | $5.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.25 Median $12.02 Typical High $14.45 | Professional | None | $5.25 | $12.02 | $14.45 |
Highmark BCBS Setting Facility Modifier None Typical Low $9.55 Median $23.44 Typical High $54.95 | Facility | None | $9.55 | $23.44 | $54.95 |
MVP Health Care Setting Facility Modifier None Typical Low $11.22 Median $19.95 Typical High $257.04 | Facility | None | $11.22 | $19.95 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $43.65 | Professional | None | $10.72 | $10.72 | $43.65 |
United Setting Facility Modifier None Typical Low $10.96 Median $12.02 Typical High $23.99 | Facility | None | $10.96 | $12.02 | $23.99 |
United Setting Professional Modifier None Typical Low $5.01 Median $7.24 Typical High $18.20 | Professional | None | $5.01 | $7.24 | $18.20 |
Univera Setting Facility Modifier None Typical Low $5.25 Median $5.25 Typical High $30.90 | Facility | None | $5.25 | $5.25 | $30.90 |
Univera Setting Professional Modifier None Typical Low $5.25 Median $12.02 Typical High $18.20 | Professional | None | $5.25 | $12.02 | $18.20 |
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 $2.63 Median $2.63 Typical High $2.63 | Professional | 59 · Distinct service | $2.63 | $2.63 | $2.63 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 90 · Outside lab | $7.94 | $7.94 | $7.94 |
Where New York sits
The same service costs 7.6 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· 47th of 51
$11.48
VT $72.44MD $9.55
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.