How much rates vary
Facilitymedian $5 · 10th to 90th $4 to $18Professionalmedian $5 · 10th to 90th $3 to $12
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 $3.80 Median $4.37 Typical High $12.88 | Facility | None | $3.80 | $4.37 | $12.88 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $4.37 Typical High $10.00 | Professional | None | $3.80 | $4.37 | $10.00 |
Ambetter Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $13.49 | Facility | None | $5.13 | $5.13 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.57 Median $4.17 Typical High $13.80 | Professional | None | $2.57 | $4.17 | $13.80 |
CDPHP Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $12.30 Typical High $56.23 | Facility | None | $5.01 | $12.30 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $7.08 Typical High $36.31 | Professional | None | $4.17 | $7.08 | $36.31 |
Emblem Health Setting Facility Modifier None Typical Low $2.51 Median $5.13 Typical High $11.75 | Facility | None | $2.51 | $5.13 | $11.75 |
Emblem Health Setting Professional Modifier None Typical Low $2.45 Median $3.63 Typical High $10.00 | Professional | None | $2.45 | $3.63 | $10.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $6.17 | Professional | None | $4.37 | $5.13 | $6.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $4.07 Median $12.02 Typical High $30.90 | Facility | None | $4.07 | $12.02 | $30.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | None | $3.63 | $3.63 | $3.63 |
MVP Health Care Setting Facility Modifier None Typical Low $6.17 Median $10.47 Typical High $257.04 | Facility | None | $6.17 | $10.47 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $10.72 | Professional | None | $4.17 | $4.17 | $10.72 |
United Setting Facility Modifier None Typical Low $4.68 Median $5.13 Typical High $6.46 | Facility | None | $4.68 | $5.13 | $6.46 |
United Setting Professional Modifier None Typical Low $2.34 Median $3.16 Typical High $7.76 | Professional | None | $2.34 | $3.16 | $7.76 |
Univera Setting Facility Modifier None Typical Low $3.39 Median $4.79 Typical High $13.18 | Facility | None | $3.39 | $4.79 | $13.18 |
Univera Setting Professional Modifier None Typical Low $3.39 Median $5.13 Typical High $6.17 | Professional | None | $3.39 | $5.13 | $6.17 |
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 $1.91 Median $1.91 Typical High $2.19 | Professional | 52 · Reduced service | $1.91 | $1.91 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.87 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.87 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $5.13 Median $7.76 Typical High $11.75 | Facility | QW · Waived lab test | $5.13 | $7.76 | $11.75 |
United Setting Professional Modifier QW · Waived lab test Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | QW · Waived lab test | $3.16 | $3.16 | $3.16 |
Where New York sits
The same service costs 12.6 times more in Minnesota than in Washington, DC. 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· 46th of 51
$4.79
MN $52.48DC $4.17
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.