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 $1.86 Median $2.34 Typical High $5.89 | Facility | None | $1.86 | $2.34 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $2.34 Typical High $3.31 | Professional | None | $1.78 | $2.34 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $1.45 Median $1.45 Typical High $4.37 | Facility | None | $1.45 | $1.45 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $2.45 Typical High $14.13 | Professional | None | $1.58 | $2.45 | $14.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $6.03 | Facility | None | $5.62 | $5.62 | $6.03 |
United Setting Professional Modifier None Typical Low $1.45 Median $2.19 Typical High $3.16 | Professional | None | $1.45 | $2.19 | $3.16 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier 59 · Distinct service + GC · Resident with teaching physician + QW · Waived lab test + SA · Nurse practitioner Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 59 · Distinct service + GC · Resident with teaching physician + QW · Waived lab test + SA · Nurse practitioner | $1.70 | $1.70 | $1.70 |
Where Delaware sits
The same service costs 20.4 times more in Vermont than in Washington, DC. 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.
Delaware· 32nd of 51
$2.34
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.