How much rates vary
Facilitymedian $26 · 10th to 90th $14 to $62Professionalmedian $43 · 10th to 90th $25 to $56
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 $20.89 Median $43.65 Typical High $77.62 | Facility | None | $20.89 | $43.65 | $77.62 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $10.47 Median $20.89 Typical High $25.12 | Facility | 52 · Reduced service | $10.47 | $20.89 | $25.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.17 Median $8.32 Typical High $10.00 | Facility | 53 · Discontinued | $4.17 | $8.32 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $42.66 Typical High $56.23 | Professional | None | $20.89 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $18.62 Typical High $22.91 | Professional | 52 · Reduced service | $10.47 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $7.41 Typical High $9.33 | Professional | 53 · Discontinued | $4.17 | $7.41 | $9.33 |
Ambetter Setting Professional Modifier None Typical Low $17.38 Median $36.31 Typical High $45.71 | Professional | None | $17.38 | $36.31 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $42.66 Typical High $48.98 | Professional | None | $35.48 | $42.66 | $48.98 |
CDPHP Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $64.57 | Professional | None | $33.88 | $33.88 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $190.55 | Facility | None | $37.15 | $37.15 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $47.86 Typical High $48.98 | Professional | None | $33.11 | $47.86 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $20.89 Typical High $52.48 | Facility | None | $0.10 | $20.89 | $52.48 |
Emblem Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.80 Median $14.45 Typical High $25.70 | Facility | None | $13.80 | $14.45 | $25.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $20.89 Median $36.31 Typical High $48.98 | Professional | None | $20.89 | $36.31 | $48.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $54.95 Median $58.88 Typical High $549.54 | Facility | None | $54.95 | $58.88 | $549.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
MVP Health Care Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
MVP Health Care Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | None | $40.74 | $40.74 | $61.66 |
Optum Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | None | $42.66 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $21.88 Median $44.67 Typical High $63.10 | Professional | None | $21.88 | $44.67 | $63.10 |
Univera Setting Facility Modifier None Typical Low $13.80 Median $14.45 Typical High $38.90 | Facility | None | $13.80 | $14.45 | $38.90 |
Univera Setting Professional Modifier None Typical Low $20.89 Median $38.90 Typical High $48.98 | Professional | None | $20.89 | $38.90 | $48.98 |
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 $56.23 Median $57.54 Typical High $61.66 | Facility | AF · Specialist physician | $56.23 | $57.54 | $61.66 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $42.66 Median $43.65 Typical High $46.77 | Facility | HO · Master's level | $42.66 | $43.65 | $46.77 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $47.86 Median $48.98 Typical High $52.48 | Facility | TD · Registered nurse | $47.86 | $48.98 | $52.48 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $46.77 Median $56.23 Typical High $60.26 | Professional | AF · Specialist physician | $46.77 | $56.23 | $60.26 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $34.67 Median $42.66 Typical High $44.67 | Professional | HO · Master's level | $34.67 | $42.66 | $44.67 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $39.81 Median $47.86 Typical High $51.29 | Professional | TD · Registered nurse | $39.81 | $47.86 | $51.29 |
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 XP · Separate practitioner Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | XP · Separate practitioner | $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 Hawaii than in Washington, DC. 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· 22nd of 51
$42.66
HI $63.10DC $26.92
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.