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 $6.46 Median $11.75 Typical High $34.67 | Facility | None | $6.46 | $11.75 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $6.92 Typical High $11.75 | Professional | None | $6.46 | $6.92 | $11.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $36.31 | Facility | None | $13.80 | $13.80 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.89 Median $9.55 Typical High $28.84 | Professional | None | $5.89 | $9.55 | $28.84 |
CDPHP Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $29.51 Typical High $95.50 | Facility | None | $13.49 | $29.51 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $16.22 Typical High $81.28 | Professional | None | $8.91 | $16.22 | $81.28 |
Emblem Health Setting Facility Modifier None Typical Low $8.51 Median $14.13 Typical High $30.90 | Facility | None | $8.51 | $14.13 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $6.46 Median $9.77 Typical High $26.92 | Professional | None | $6.46 | $9.77 | $26.92 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $15.49 | Professional | None | $10.00 | $13.80 | $15.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $15.14 Median $23.99 Typical High $69.18 | Facility | None | $15.14 | $23.99 | $69.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $8.32 Median $9.12 Typical High $9.12 | Professional | None | $8.32 | $9.12 | $9.12 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $25.12 Typical High $257.04 | Facility | None | $13.80 | $25.12 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $28.18 | Professional | None | $9.33 | $9.33 | $28.18 |
United Setting Facility Modifier None Typical Low $12.30 Median $13.80 Typical High $17.38 | Facility | None | $12.30 | $13.80 | $17.38 |
United Setting Professional Modifier None Typical Low $5.75 Median $8.32 Typical High $20.89 | Professional | None | $5.75 | $8.32 | $20.89 |
Univera Setting Facility Modifier None Typical Low $9.12 Median $13.80 Typical High $28.84 | Facility | None | $9.12 | $13.80 | $28.84 |
Univera Setting Professional Modifier None Typical Low $9.12 Median $13.80 Typical High $17.78 | Professional | None | $9.12 | $13.80 | $17.78 |
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 $3.24 Median $3.24 Typical High $5.89 | Professional | 52 · Reduced service | $3.24 | $3.24 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.29 Typical High $2.34 | Professional | 53 · Discontinued | $1.29 | $1.29 | $2.34 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 90 · Outside lab | $5.50 | $5.50 | $5.50 |
Where New York sits
The same service costs 3.7 times more in Kansas than in New Jersey. 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
$12.02
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.