How much rates vary
Facilitymedian $15 · 10th to 90th $10 to $52Professionalmedian $12 · 10th to 90th $7 to $32
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 $10.47 Median $12.02 Typical High $35.48 | Facility | None | $10.47 | $12.02 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $12.02 Typical High $19.95 | Professional | None | $10.47 | $12.02 | $19.95 |
Ambetter Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $37.15 | Facility | None | $14.13 | $14.13 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $11.48 Typical High $38.90 | Professional | None | $7.08 | $11.48 | $38.90 |
CDPHP Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $30.90 Typical High $154.88 | Facility | None | $13.80 | $30.90 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $19.50 Typical High $87.10 | Professional | None | $10.00 | $19.50 | $87.10 |
Emblem Health Setting Facility Modifier None Typical Low $7.59 Median $15.49 Typical High $32.36 | Facility | None | $7.59 | $15.49 | $32.36 |
Emblem Health Setting Professional Modifier None Typical Low $6.76 Median $10.00 Typical High $27.54 | Professional | None | $6.76 | $10.00 | $27.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $15.85 | Professional | None | $10.00 | $14.13 | $15.85 |
Highmark BCBS Setting Facility Modifier None Typical Low $11.22 Median $37.15 Typical High $79.43 | Facility | None | $11.22 | $37.15 | $79.43 |
Highmark BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.55 Typical High $10.72 | Professional | None | $9.33 | $9.55 | $10.72 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $21.88 Typical High $257.04 | Facility | None | $13.80 | $21.88 | $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 $14.13 Typical High $17.78 | Facility | None | $12.88 | $14.13 | $17.78 |
United Setting Professional Modifier None Typical Low $6.03 Median $8.51 Typical High $21.38 | Professional | None | $6.03 | $8.51 | $21.38 |
Univera Setting Facility Modifier None Typical Low $9.33 Median $10.00 Typical High $36.31 | Facility | None | $9.33 | $10.00 | $36.31 |
Univera Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $16.98 | Professional | None | $9.33 | $14.13 | $16.98 |
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 $5.25 Median $5.25 Typical High $6.03 | Professional | 52 · Reduced service | $5.25 | $5.25 | $6.03 |
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 |
Emblem Health Setting Facility Modifier QW · Waived lab test Typical Low $14.13 Median $21.38 Typical High $32.36 | Facility | QW · Waived lab test | $14.13 | $21.38 | $32.36 |
United Setting Professional Modifier QW · Waived lab test Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | QW · Waived lab test | $8.71 | $8.71 | $8.71 |
Where New York sits
The same service costs 9.5 times more in Vermont than in Indiana. 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· 41st of 51
$12.88
VT $107IN $11.22
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.