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 Professional Modifier None (both parts) Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None (both parts) | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 26 · Professional part | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | TC · Technical part | $3.39 | $3.39 | $3.39 |
CareSource Setting Professional Modifier None (both parts) Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None (both parts) | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $13.49 Median $18.20 Typical High $38.02 | Professional | None (both parts) | $13.49 | $18.20 | $38.02 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $10.72 Median $14.45 Typical High $33.11 | Professional | 26 · Professional part | $10.72 | $14.45 | $33.11 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $2.88 Median $3.80 Typical High $5.13 | Professional | TC · Technical part | $2.88 | $3.80 | $5.13 |
United Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
United Setting Professional Modifier None (both parts) Typical Low $11.22 Median $12.88 Typical High $52.48 | Professional | None (both parts) | $11.22 | $12.88 | $52.48 |
United Setting Professional Modifier 26 · Professional part Typical Low $8.71 Median $10.47 Typical High $18.62 | Professional | 26 · Professional part | $8.71 | $10.47 | $18.62 |
United Setting Professional Modifier TC · Technical part Typical Low $2.04 Median $2.34 Typical High $35.48 | Professional | TC · Technical part | $2.04 | $2.34 | $35.48 |
2 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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Where West Virginia sits
The same service costs 2.6 times more in California than in New York. 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.
West Virginia· 42nd of 51
$16.22
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.