How much rates vary
Facilitymedian $117 · 10th to 90th $28 to $240Professionalmedian $123 · 10th to 90th $100 to $155
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 $91.20 Median $125.89 Typical High $194.98 | Facility | None | $91.20 | $125.89 | $194.98 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $44.67 Median $56.23 Typical High $70.79 | Facility | 52 · Reduced service | $44.67 | $56.23 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $28.18 | Facility | 53 · Discontinued | $18.20 | $22.39 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $154.88 | Professional | None | $91.20 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $56.23 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.39 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $22.39 | $27.54 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $125.89 | Professional | None | $79.43 | $120.23 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $141.25 | Professional | None | $102.33 | $123.03 | $141.25 |
CDPHP Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $186.21 | Professional | None | $151.36 | $151.36 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $380.19 | Facility | None | $169.82 | $169.82 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $144.54 | Professional | None | $97.72 | $134.90 | $144.54 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $89.13 Typical High $245.47 | Facility | None | $0.10 | $89.13 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $134.90 | Facility | None | $27.54 | $27.54 | $134.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $151.36 | Professional | None | $60.26 | $102.33 | $151.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $1,513.56 | Facility | None | $162.18 | $208.93 | $1,513.56 |
Highmark BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $109.65 Median $109.65 Typical High $190.55 | Professional | None | $109.65 | $109.65 | $190.55 |
Optum Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | None | $128.82 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $870.96 Typical High $1,071.52 | Facility | None | $758.58 | $870.96 | $1,071.52 |
United Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $208.93 | Professional | None | $91.20 | $134.90 | $208.93 |
Univera Setting Facility Modifier None Typical Low $27.54 Median $112.20 Typical High $134.90 | Facility | None | $27.54 | $112.20 | $134.90 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $151.36 | Professional | None | $60.26 | $114.82 | $151.36 |
8 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 $154.88 Median $165.96 Typical High $173.78 | Facility | AF · Specialist physician | $154.88 | $165.96 | $173.78 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $117.49 Median $123.03 Typical High $128.82 | Facility | HO · Master's level | $117.49 | $123.03 | $128.82 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $131.83 Median $141.25 Typical High $147.91 | Facility | TD · Registered nurse | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $141.25 Median $154.88 Typical High $173.78 | Professional | AF · Specialist physician | $141.25 | $154.88 | $173.78 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $107.15 Median $117.49 Typical High $128.82 | Professional | HO · Master's level | $107.15 | $117.49 | $128.82 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $120.23 Median $131.83 Typical High $147.91 | Professional | TD · Registered nurse | $120.23 | $131.83 | $147.91 |
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 2.3 times more in Alaska 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.
New York· 27th of 51
$123
AK $224KY $95.50
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.