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 $11.22 Median $12.88 Typical High $38.02 | Facility | None | $11.22 | $12.88 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | None | $11.22 | $11.22 | $13.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $38.90 | Facility | None | $15.14 | $15.14 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.41 Median $11.48 Typical High $38.90 | Professional | None | $7.41 | $11.48 | $38.90 |
CDPHP Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $14.79 Median $33.11 Typical High $162.18 | Facility | None | $14.79 | $33.11 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $20.42 Typical High $97.72 | Professional | None | $10.47 | $20.42 | $97.72 |
Emblem Health Setting Facility Modifier None Typical Low $7.59 Median $15.14 Typical High $33.88 | Facility | None | $7.59 | $15.14 | $33.88 |
Emblem Health Setting Professional Modifier None Typical Low $7.08 Median $10.47 Typical High $28.84 | Professional | None | $7.08 | $10.47 | $28.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $16.98 | Professional | None | $9.77 | $15.14 | $16.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $13.49 Median $19.05 Typical High $40.74 | Facility | None | $13.49 | $19.05 | $40.74 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $26.92 Typical High $257.04 | Facility | None | $13.80 | $26.92 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $93.33 | Professional | None | $12.02 | $12.02 | $93.33 |
United Setting Facility Modifier None Typical Low $13.49 Median $15.14 Typical High $18.62 | Facility | None | $13.49 | $15.14 | $18.62 |
United Setting Professional Modifier None Typical Low $6.31 Median $9.12 Typical High $22.39 | Professional | None | $6.31 | $9.12 | $22.39 |
Univera Setting Facility Modifier None Typical Low $9.77 Median $15.14 Typical High $23.44 | Facility | None | $9.77 | $15.14 | $23.44 |
Univera Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $19.50 | Professional | None | $9.77 | $15.14 | $19.50 |
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 $5.62 Median $5.62 Typical High $6.46 | Professional | 52 · Reduced service | $5.62 | $5.62 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.57 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.57 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 59 · Distinct service | $3.80 | $3.80 | $3.80 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 90 · Outside lab | $10.00 | $10.00 | $10.00 |
Where New York sits
The same service costs 4.3 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· 33rd of 51
$14.13
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.