How much rates vary
Facilitymedian $11 · 10th to 90th $8 to $38Professionalmedian $9 · 10th to 90th $5 to $23
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 $7.59 Median $8.71 Typical High $26.30 | Facility | None | $7.59 | $8.71 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $8.71 Typical High $13.49 | Professional | None | $7.59 | $8.71 | $13.49 |
Ambetter Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $26.92 | Facility | None | $10.23 | $10.23 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $8.32 Typical High $28.18 | Professional | None | $5.13 | $8.32 | $28.18 |
CDPHP Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $22.39 Typical High $112.20 | Facility | None | $10.00 | $22.39 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $14.13 Typical High $60.26 | Professional | None | $7.08 | $14.13 | $60.26 |
Emblem Health Setting Facility Modifier None Typical Low $6.46 Median $10.47 Typical High $23.44 | Facility | None | $6.46 | $10.47 | $23.44 |
Emblem Health Setting Professional Modifier None Typical Low $4.90 Median $7.24 Typical High $19.95 | Professional | None | $4.90 | $7.24 | $19.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Facility | None | $10.23 | $10.23 | $10.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.71 Median $10.23 Typical High $12.30 | Professional | None | $8.71 | $10.23 | $12.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $7.59 Median $25.70 Typical High $54.95 | Facility | None | $7.59 | $25.70 | $54.95 |
Highmark BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.92 Typical High $12.02 | Professional | None | $6.17 | $6.92 | $12.02 |
MVP Health Care Setting Facility Modifier None Typical Low $12.88 Median $19.50 Typical High $257.04 | Facility | None | $12.88 | $19.50 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $21.38 | Professional | None | $8.32 | $8.32 | $21.38 |
United Setting Facility Modifier None Typical Low $9.33 Median $10.23 Typical High $12.88 | Facility | None | $9.33 | $10.23 | $12.88 |
United Setting Professional Modifier None Typical Low $4.37 Median $6.31 Typical High $15.49 | Professional | None | $4.37 | $6.31 | $15.49 |
Univera Setting Facility Modifier None Typical Low $6.76 Median $10.23 Typical High $26.30 | Facility | None | $6.76 | $10.23 | $26.30 |
Univera Setting Professional Modifier None Typical Low $6.76 Median $10.23 Typical High $13.18 | Professional | None | $6.76 | $10.23 | $13.18 |
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 $3.80 Median $3.80 Typical High $4.37 | Professional | 52 · Reduced service | $3.80 | $3.80 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $1.78 | Professional | 53 · Discontinued | $1.51 | $1.51 | $1.78 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 59 · Distinct service | $8.91 | $8.91 | $8.91 |
Where New York sits
The same service costs 12.6 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· 31st of 51
$10.23
VT $97.72MD $7.76
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.