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 $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 $11.75 Typical High $19.05 | Professional | None | $10.72 | $11.75 | $19.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $37.15 | Facility | None | $14.45 | $14.45 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $10.96 Typical High $38.02 | Professional | None | $7.08 | $10.96 | $38.02 |
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 $30.90 Typical High $154.88 | Facility | None | $14.13 | $30.90 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $19.50 Typical High $95.50 | Professional | None | $10.00 | $19.50 | $95.50 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $14.45 Typical High $32.36 | Facility | None | $7.08 | $14.45 | $32.36 |
Emblem Health Setting Professional Modifier None Typical Low $6.76 Median $10.00 Typical High $28.18 | Professional | None | $6.76 | $10.00 | $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 $8.32 Median $14.45 Typical High $16.22 | Professional | None | $8.32 | $14.45 | $16.22 |
Highmark BCBS Setting Facility Modifier None Typical Low $12.30 Median $28.84 Typical High $66.07 | Facility | None | $12.30 | $28.84 | $66.07 |
Highmark BCBS Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $9.55 | Professional | None | $8.71 | $9.55 | $9.55 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $25.70 Typical High $257.04 | Facility | None | $13.80 | $25.70 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $29.51 | Professional | None | $11.48 | $11.48 | $29.51 |
United Setting Facility Modifier None Typical Low $12.88 Median $14.45 Typical High $17.78 | Facility | None | $12.88 | $14.45 | $17.78 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.71 Typical High $21.38 | Professional | None | $6.03 | $8.71 | $21.38 |
Univera Setting Facility Modifier None Typical Low $9.33 Median $14.45 Typical High $23.99 | Facility | None | $9.33 | $14.45 | $23.99 |
Univera Setting Professional Modifier None Typical Low $8.51 Median $14.45 Typical High $18.62 | Professional | None | $8.51 | $14.45 | $18.62 |
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 $3.63 Median $3.63 Typical High $3.63 | Professional | 90 · Outside lab | $3.63 | $3.63 | $3.63 |
Where New York sits
The same service costs 8.3 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· 34th of 51
$13.80
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.