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 $19.50 Median $20.42 Typical High $45.71 | Facility | None | $19.50 | $20.42 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $37.15 | Professional | None | $19.05 | $20.42 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $23.99 Typical High $25.12 | Facility | None | $15.14 | $23.99 | $25.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $33.88 Typical High $33.88 | Professional | None | $12.02 | $33.88 | $33.88 |
CareSource Setting Facility Modifier None Typical Low $23.99 Median $28.84 Typical High $33.88 | Facility | None | $23.99 | $28.84 | $33.88 |
CareSource Setting Professional Modifier None Typical Low $23.99 Median $27.54 Typical High $39.81 | Professional | None | $23.99 | $27.54 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $51.29 Typical High $51.29 | Facility | None | $20.89 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $114.82 Typical High $114.82 | Professional | None | $12.88 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $10.00 Median $19.95 Typical High $33.11 | Professional | None | $10.00 | $19.95 | $33.11 |
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 $9.77 Median $10.00 Typical High $18.62 | Professional | 52 · Reduced service | $9.77 | $10.00 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.07 Typical High $7.41 | Professional | 53 · Discontinued | $3.89 | $4.07 | $7.41 |
Ambetter Setting Professional Modifier QW · Waived lab test Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | QW · Waived lab test | $20.42 | $20.42 | $20.42 |
Where Kentucky sits
The same service costs 3.6 times more in Hawaii 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.
Kentucky· 10th of 51
$28.18
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.