How much rates vary
Facilitymedian $115 · 10th to 90th $28 to $224Professionalmedian $123 · 10th to 90th $102 to $162
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $109.65 Median $131.83 Typical High $281.84 | Facility | None | $109.65 | $131.83 | $281.84 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $54.95 Median $58.88 Typical High $74.13 | Facility | 52 · Reduced service | $54.95 | $58.88 | $74.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $29.51 | Facility | 53 · Discontinued | $21.88 | $23.44 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $162.18 | Professional | None | $109.65 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $54.95 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $23.44 | $28.84 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $104.71 Typical High $134.90 | Professional | None | $41.69 | $104.71 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $138.04 | Professional | None | $100.00 | $120.23 | $138.04 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | None | $181.97 | $181.97 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $407.38 | Facility | None | $181.97 | $181.97 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $281.84 | Professional | None | $89.13 | $109.65 | $281.84 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $109.65 Typical High $269.15 | Facility | None | $0.10 | $109.65 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $27.54 Median $33.11 Typical High $131.83 | Facility | None | $27.54 | $33.11 | $131.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $151.36 | Professional | None | $60.26 | $104.71 | $151.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $173.78 Median $199.53 Typical High $1,096.48 | Facility | None | $173.78 | $199.53 | $1,096.48 |
Highmark BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | None | $138.04 | $138.04 | $169.82 |
MVP Health Care Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
MVP Health Care Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | None | $114.82 | $114.82 | $199.53 |
Optum Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | None | $100.00 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $371.54 | Facility | None | $257.04 | $302.00 | $371.54 |
United Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $199.53 | Professional | None | $100.00 | $104.71 | $199.53 |
Univera Setting Facility Modifier None Typical Low $27.54 Median $74.13 Typical High $154.88 | Facility | None | $27.54 | $74.13 | $154.88 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $154.88 | Professional | None | $60.26 | $117.49 | $154.88 |
9 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 Facility Modifier AF · Specialist physician Typical Low $162.18 Median $169.82 Typical High $177.83 | Facility | AF · Specialist physician | $162.18 | $169.82 | $177.83 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $123.03 Median $125.89 Typical High $131.83 | Facility | HO · Master's level | $123.03 | $125.89 | $131.83 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $138.04 Median $144.54 Typical High $151.36 | Facility | TD · Registered nurse | $138.04 | $144.54 | $151.36 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $144.54 Median $162.18 Typical High $169.82 | Professional | AF · Specialist physician | $144.54 | $162.18 | $169.82 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $107.15 Median $123.03 Typical High $128.82 | Professional | HO · Master's level | $107.15 | $123.03 | $128.82 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $123.03 Median $138.04 Typical High $144.54 | Professional | TD · Registered nurse | $123.03 | $138.04 | $144.54 |
Emblem Health Setting Facility Modifier 59 · Distinct service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 59 · Distinct service | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U4 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U4 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier XU · Unusual separate service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | XU · Unusual separate service | $0.10 | $0.10 | $0.10 |
Where New York sits
The same service costs 2.4 times more in Alaska than in Ohio. 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.
New York· 33rd of 51
$123
AK $245OH $102
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.