How much rates vary
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 $4.17 Median $4.79 Typical High $14.13 | Facility | None | $4.17 | $4.79 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $4.57 Typical High $7.94 | Professional | None | $4.17 | $4.57 | $7.94 |
Ambetter Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $14.79 | Facility | None | $5.62 | $5.62 | $14.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $4.57 Typical High $15.14 | Professional | None | $2.82 | $4.57 | $15.14 |
CDPHP Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $13.49 Typical High $60.26 | Facility | None | $5.50 | $13.49 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $4.07 Median $7.76 Typical High $38.02 | Professional | None | $4.07 | $7.76 | $38.02 |
Emblem Health Setting Facility Modifier None Typical Low $5.01 Median $7.41 Typical High $12.88 | Facility | None | $5.01 | $7.41 | $12.88 |
Emblem Health Setting Professional Modifier None Typical Low $2.63 Median $3.98 Typical High $10.96 | Professional | None | $2.63 | $3.98 | $10.96 |
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 $4.79 Median $5.62 Typical High $6.76 | Professional | None | $4.79 | $5.62 | $6.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.89 Median $11.22 Typical High $42.66 | Facility | None | $3.89 | $11.22 | $42.66 |
Highmark BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.72 Typical High $3.80 | Professional | None | $3.39 | $3.72 | $3.80 |
MVP Health Care Setting Facility Modifier None Typical Low $6.76 Median $11.22 Typical High $257.04 | Facility | None | $6.76 | $11.22 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $11.75 | Professional | None | $4.57 | $4.57 | $11.75 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.62 Typical High $7.08 | Facility | None | $5.13 | $5.62 | $7.08 |
United Setting Professional Modifier None Typical Low $2.40 Median $3.72 Typical High $8.71 | Professional | None | $2.40 | $3.72 | $8.71 |
Univera Setting Facility Modifier None Typical Low $3.72 Median $5.25 Typical High $14.45 | Facility | None | $3.72 | $5.25 | $14.45 |
Univera Setting Professional Modifier None Typical Low $3.72 Median $5.62 Typical High $6.76 | Professional | None | $3.72 | $5.62 | $6.76 |
2 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 $2.09 Median $2.09 Typical High $2.40 | Professional | 52 · Reduced service | $2.09 | $2.09 | $2.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $0.83 Typical High $0.95 | Professional | 53 · Discontinued | $0.83 | $0.83 | $0.95 |
Where New York sits
The same service costs 13.5 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· 38th of 51
$5.25
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.