How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $56.23 Median $58.88 Typical High $87.10 | Facility | None | $56.23 | $58.88 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $104.71 | Professional | None | $52.48 | $63.10 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $70.79 Typical High $74.13 | Facility | None | $43.65 | $70.79 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $74.13 | Professional | None | $34.67 | $34.67 | $74.13 |
CareSource Setting Facility Modifier None Typical Low $63.10 Median $85.11 Typical High $97.72 | Facility | None | $63.10 | $85.11 | $97.72 |
CareSource Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $112.20 | Professional | None | $70.79 | $87.10 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $165.96 | Facility | None | $60.26 | $102.33 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $338.84 Typical High $338.84 | Professional | None | $39.81 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $38.90 Median $52.48 Typical High $117.49 | Professional | None | $38.90 | $52.48 | $117.49 |
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 $26.30 Median $28.18 Typical High $43.65 | Professional | 52 · Reduced service | $26.30 | $28.18 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $17.38 | Professional | 53 · Discontinued | $10.47 | $11.48 | $17.38 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $23.99 Median $23.99 Typical High $60.26 | Professional | QW · Waived lab test | $23.99 | $23.99 | $60.26 |
Anthem BCBS Setting Professional Modifier QW · Waived lab test Typical Low $64.57 Median $70.79 Typical High $131.83 | Professional | QW · Waived lab test | $64.57 | $70.79 | $131.83 |
Where Kentucky sits
The same service costs 4.0 times more in Alaska than in Alabama. 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.
Kentucky· 42nd of 51
$58.88
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.