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 $6.31 Median $7.24 Typical High $21.38 | Facility | None | $6.31 | $7.24 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $6.31 Median $6.61 Typical High $10.96 | Professional | None | $6.31 | $6.61 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $21.88 | Facility | None | $8.32 | $8.32 | $21.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $6.76 Typical High $22.91 | Professional | None | $4.17 | $6.76 | $22.91 |
CDPHP Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $18.62 Typical High $91.20 | Facility | None | $8.13 | $18.62 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $5.62 Median $11.48 Typical High $54.95 | Professional | None | $5.62 | $11.48 | $54.95 |
Emblem Health Setting Facility Modifier None Typical Low $6.46 Median $10.23 Typical High $19.05 | Facility | None | $6.46 | $10.23 | $19.05 |
Emblem Health Setting Professional Modifier None Typical Low $3.98 Median $5.89 Typical High $16.22 | Professional | None | $3.98 | $5.89 | $16.22 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Facility | None | $8.32 | $8.32 | $8.32 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.08 Median $8.32 Typical High $11.22 | Professional | None | $7.08 | $8.32 | $11.22 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.03 Median $16.60 Typical High $63.10 | Facility | None | $6.03 | $16.60 | $63.10 |
MVP Health Care Setting Facility Modifier None Typical Low $10.47 Median $15.85 Typical High $257.04 | Facility | None | $10.47 | $15.85 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $17.38 | Professional | None | $6.76 | $6.76 | $17.38 |
United Setting Facility Modifier None Typical Low $7.59 Median $8.32 Typical High $18.20 | Facility | None | $7.59 | $8.32 | $18.20 |
United Setting Professional Modifier None Typical Low $3.55 Median $5.50 Typical High $12.88 | Professional | None | $3.55 | $5.50 | $12.88 |
Univera Setting Facility Modifier None Typical Low $5.50 Median $8.32 Typical High $21.38 | Facility | None | $5.50 | $8.32 | $21.38 |
Univera Setting Professional Modifier None Typical Low $5.50 Median $8.32 Typical High $13.49 | Professional | None | $5.50 | $8.32 | $13.49 |
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 $3.09 Median $3.09 Typical High $3.55 | Professional | 52 · Reduced service | $3.09 | $3.09 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.26 Typical High $1.45 | Professional | 53 · Discontinued | $1.26 | $1.26 | $1.45 |
Highmark BCBS Setting Professional Modifier 90 · Outside lab Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 90 · Outside lab | $5.62 | $5.62 | $5.62 |
Where New York sits
The same service costs 10.0 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· 35th of 51
$8.32
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.