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 $3.24 Median $4.37 Typical High $10.96 | Facility | None | $3.24 | $4.37 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $5.37 | Professional | None | $3.24 | $3.24 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $11.48 | Facility | None | $4.37 | $4.37 | $11.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $3.55 Typical High $11.75 | Professional | None | $2.19 | $3.55 | $11.75 |
CDPHP Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $10.47 Typical High $47.86 | Facility | None | $4.27 | $10.47 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $6.03 Typical High $30.20 | Professional | None | $3.09 | $6.03 | $30.20 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $5.62 Typical High $10.00 | Facility | None | $3.47 | $5.62 | $10.00 |
Emblem Health Setting Professional Modifier None Typical Low $2.04 Median $3.09 Typical High $8.51 | Professional | None | $2.04 | $3.09 | $8.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.72 Median $4.37 Typical High $4.90 | Professional | None | $3.72 | $4.37 | $4.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.72 Median $12.02 Typical High $21.38 | Facility | None | $3.72 | $12.02 | $21.38 |
MVP Health Care Setting Facility Modifier None Typical Low $4.79 Median $8.71 Typical High $257.04 | Facility | None | $4.79 | $8.71 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $9.12 | Professional | None | $3.55 | $3.55 | $9.12 |
United Setting Facility Modifier None Typical Low $3.98 Median $4.37 Typical High $15.14 | Facility | None | $3.98 | $4.37 | $15.14 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.88 Typical High $6.61 | Professional | None | $1.86 | $2.88 | $6.61 |
Univera Setting Facility Modifier None Typical Low $2.88 Median $3.72 Typical High $11.22 | Facility | None | $2.88 | $3.72 | $11.22 |
Univera Setting Professional Modifier None Typical Low $2.88 Median $4.37 Typical High $5.25 | Professional | None | $2.88 | $4.37 | $5.25 |
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 $1.62 Median $1.62 Typical High $1.86 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.76 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.76 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 90 · Outside lab | $1.51 | $1.51 | $1.51 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 90 · Outside lab | $2.95 | $2.95 | $2.95 |
Where New York sits
The same service costs 4.2 times more in Kansas 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
$3.89
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.