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 $10.00 Median $10.00 Typical High $26.30 | Facility | None | $10.00 | $10.00 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $26.30 | Professional | None | $10.00 | $12.59 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $14.13 Typical High $77.62 | Professional | None | $5.89 | $14.13 | $77.62 |
Highmark BCBS Setting Facility Modifier None Typical Low $32.36 Median $93.33 Typical High $169.82 | Facility | None | $32.36 | $93.33 | $169.82 |
United Setting Professional Modifier None Typical Low $8.71 Median $12.30 Typical High $13.18 | Professional | None | $8.71 | $12.30 | $13.18 |
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 + TB · 340B drug + XE · Separate encounter Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 59 · Distinct service + GC · Resident with teaching physician + TB · 340B drug + XE · Separate encounter | $18.62 | $18.62 | $18.62 |
Where Delaware sits
The same service costs 5.6 times more in Alabama than in Kentucky. 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· 24th of 51
$14.79
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.