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 $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $44.67 Typical High $57.54 | Professional | None (both parts) | $44.67 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $3.47 Median $3.80 Typical High $3.98 | Professional | 26 · Professional part | $3.47 | $3.80 | $3.98 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $40.74 Typical High $53.70 | Professional | TC · Technical part | $40.74 | $40.74 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $41.69 Median $64.57 Typical High $77.62 | Professional | None (both parts) | $41.69 | $64.57 | $77.62 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $3.24 Median $3.47 Typical High $5.50 | Professional | 26 · Professional part | $3.24 | $3.47 | $5.50 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $38.90 Median $61.66 Typical High $72.44 | Professional | TC · Technical part | $38.90 | $61.66 | $72.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
United Setting Professional Modifier None (both parts) Typical Low $41.69 Median $47.86 Typical High $79.43 | Professional | None (both parts) | $41.69 | $47.86 | $79.43 |
United Setting Professional Modifier 26 · Professional part Typical Low $2.88 Median $3.39 Typical High $4.79 | Professional | 26 · Professional part | $2.88 | $3.39 | $4.79 |
United Setting Professional Modifier TC · Technical part Typical Low $38.02 Median $44.67 Typical High $72.44 | Professional | TC · Technical part | $38.02 | $44.67 | $72.44 |
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 $22.39 Median $22.39 Typical High $24.55 | Professional | 52 · Reduced service | $22.39 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $9.77 | Professional | 53 · Discontinued | $8.91 | $8.91 | $9.77 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service + QW · Waived lab test Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 59 · Distinct service + QW · Waived lab test | $50.12 | $50.12 | $50.12 |
Where Delaware sits
The same service costs 3.3 times more in North Dakota than in Utah. 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· 46th of 51
$46.77
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.