How much rates vary
Facilitymedian $16 · 10th to 90th $11 to $49Professionalmedian $13 · 10th to 90th $7 to $33
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 $10.72 Median $12.30 Typical High $36.31 | Facility | None | $10.72 | $12.30 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $19.05 | Professional | None | $10.72 | $11.22 | $19.05 |
Ambetter Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | None | $6.61 | $6.61 | $7.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $38.02 | Facility | None | $14.45 | $14.45 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.24 Median $11.48 Typical High $39.81 | Professional | None | $7.24 | $11.48 | $39.81 |
CDPHP Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $34.67 Typical High $158.49 | Facility | None | $14.13 | $34.67 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $10.23 Median $19.95 Typical High $97.72 | Professional | None | $10.23 | $19.95 | $97.72 |
Emblem Health Setting Facility Modifier None Typical Low $11.22 Median $17.78 Typical High $33.11 | Facility | None | $11.22 | $17.78 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $6.92 Median $10.23 Typical High $28.18 | Professional | None | $6.92 | $10.23 | $28.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.30 Median $14.45 Typical High $19.50 | Professional | None | $12.30 | $14.45 | $19.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $11.48 Median $28.18 Typical High $64.57 | Facility | None | $11.48 | $28.18 | $64.57 |
Highmark BCBS Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $10.96 | Professional | None | $8.71 | $9.55 | $10.96 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $26.30 Typical High $257.04 | Facility | None | $13.80 | $26.30 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $30.20 | Professional | None | $11.75 | $11.75 | $30.20 |
United Setting Facility Modifier None Typical Low $13.18 Median $14.45 Typical High $18.20 | Facility | None | $13.18 | $14.45 | $18.20 |
United Setting Professional Modifier None Typical Low $6.17 Median $9.55 Typical High $22.39 | Professional | None | $6.17 | $9.55 | $22.39 |
Univera Setting Facility Modifier None Typical Low $9.55 Median $14.45 Typical High $37.15 | Facility | None | $9.55 | $14.45 | $37.15 |
Univera Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $26.30 | Professional | None | $9.55 | $14.45 | $26.30 |
3 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 $5.37 Median $5.37 Typical High $6.17 | Professional | 52 · Reduced service | $5.37 | $5.37 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.45 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.45 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 90 · Outside lab | $7.24 | $7.24 | $7.24 |
Where New York sits
The same service costs 7.9 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· 29th of 51
$14.45
VT $87.10MD $10.96
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.