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 $3.16 Median $3.72 Typical High $10.72 | Facility | None | $3.16 | $3.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $3.16 Median $3.31 Typical High $5.62 | Professional | None | $3.16 | $3.31 | $5.62 |
Ambetter Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $2.14 | Professional | None | $1.91 | $1.91 | $2.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $11.22 | Facility | None | $4.27 | $4.27 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $3.24 Typical High $11.22 | Professional | None | $2.09 | $3.24 | $11.22 |
CDPHP Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $9.55 Typical High $45.71 | Facility | None | $4.17 | $9.55 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $5.75 Typical High $30.20 | Professional | None | $3.09 | $5.75 | $30.20 |
Emblem Health Setting Facility Modifier None Typical Low $3.02 Median $4.90 Typical High $9.55 | Facility | None | $3.02 | $4.90 | $9.55 |
Emblem Health Setting Professional Modifier None Typical Low $2.00 Median $3.02 Typical High $8.32 | Professional | None | $2.00 | $3.02 | $8.32 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | None | $3.31 | $3.31 | $3.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $4.68 | Professional | None | $2.82 | $3.98 | $4.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.55 Median $10.96 Typical High $33.88 | Facility | None | $3.55 | $10.96 | $33.88 |
MVP Health Care Setting Facility Modifier None Typical Low $4.27 Median $8.51 Typical High $257.04 | Facility | None | $4.27 | $8.51 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $8.71 | Professional | None | $3.47 | $3.47 | $8.71 |
United Setting Facility Modifier None Typical Low $3.80 Median $4.27 Typical High $8.91 | Facility | None | $3.80 | $4.27 | $8.91 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.57 Typical High $6.46 | Professional | None | $1.78 | $2.57 | $6.46 |
Univera Setting Facility Modifier None Typical Low $2.82 Median $3.31 Typical High $7.24 | Facility | None | $2.82 | $3.31 | $7.24 |
Univera Setting Professional Modifier None Typical Low $2.82 Median $3.98 Typical High $4.79 | Professional | None | $2.82 | $3.98 | $4.79 |
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 $1.58 Median $1.58 Typical High $1.82 | Professional | 52 · Reduced service | $1.58 | $1.58 | $1.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.63 Median $0.63 Typical High $0.72 | Professional | 53 · Discontinued | $0.63 | $0.63 | $0.72 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 90 · Outside lab | $2.82 | $2.82 | $2.82 |
Where New York sits
The same service costs 15.1 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· 44th of 51
$3.63
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.