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 $2.24 Median $2.51 Typical High $8.91 | Facility | None | $2.24 | $2.51 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.51 Typical High $3.98 | Professional | None | $2.24 | $2.51 | $3.98 |
Ambetter Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | None | $1.35 | $1.35 | $1.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $7.76 | Facility | None | $3.02 | $3.02 | $7.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.48 Median $2.34 Typical High $8.13 | Professional | None | $1.48 | $2.34 | $8.13 |
CDPHP Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $2.88 Median $6.76 Typical High $32.36 | Facility | None | $2.88 | $6.76 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $4.07 Typical High $19.05 | Professional | None | $2.14 | $4.07 | $19.05 |
Emblem Health Setting Facility Modifier None Typical Low $3.02 Median $3.89 Typical High $7.24 | Facility | None | $3.02 | $3.89 | $7.24 |
Emblem Health Setting Professional Modifier None Typical Low $1.41 Median $2.09 Typical High $5.75 | Professional | None | $1.41 | $2.09 | $5.75 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.24 Median $3.02 Typical High $3.63 | Professional | None | $2.24 | $3.02 | $3.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.72 Median $141.25 Typical High $288.40 | Facility | None | $3.72 | $141.25 | $288.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $1.82 Median $2.00 Typical High $2.00 | Professional | None | $1.82 | $2.00 | $2.00 |
MVP Health Care Setting Facility Modifier None Typical Low $3.72 Median $6.46 Typical High $257.04 | Facility | None | $3.72 | $6.46 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $6.17 | Professional | None | $2.40 | $2.40 | $6.17 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.95 Typical High $4.47 | Professional | None | $1.26 | $1.95 | $4.47 |
Univera Setting Facility Modifier None Typical Low $1.95 Median $3.02 Typical High $7.59 | Facility | None | $1.95 | $3.02 | $7.59 |
Univera Setting Professional Modifier None Typical Low $1.95 Median $3.02 Typical High $3.89 | Professional | None | $1.95 | $3.02 | $3.89 |
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 $1.12 Median $1.12 Typical High $1.26 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.51 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 90 · Outside lab | $1.20 | $1.20 | $1.20 |
Where New York sits
The same service costs 47.9 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· 36th of 51
$3.02
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.