How much rates vary
Facilitymedian $36 · 10th to 90th $0 to $102Professionalmedian $36 · 10th to 90th $31 to $47
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 $34.67 Median $39.81 Typical High $79.43 | Facility | None | $34.67 | $39.81 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $47.86 | Professional | None | $34.67 | $39.81 | $47.86 |
Ambetter Setting Professional Modifier None Typical Low $26.92 Median $35.48 Typical High $39.81 | Professional | None | $26.92 | $35.48 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $39.81 | Professional | None | $28.84 | $34.67 | $39.81 |
CDPHP Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $147.91 | Facility | None | $58.88 | $58.88 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $39.81 | Professional | None | $30.20 | $38.90 | $39.81 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $34.67 Typical High $102.33 | Facility | None | $0.10 | $34.67 | $102.33 |
Emblem Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Excellus BCBS Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $36.31 | Facility | None | $20.89 | $20.89 | $36.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $16.60 Median $30.20 Typical High $42.66 | Professional | None | $16.60 | $30.20 | $42.66 |
Highmark BCBS Setting Facility Modifier None Typical Low $46.77 Median $47.86 Typical High $64.57 | Facility | None | $46.77 | $47.86 | $64.57 |
Highmark BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
MVP Health Care Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $56.23 | Professional | None | $34.67 | $34.67 | $56.23 |
Optum Setting Professional Modifier None Typical Low $33.88 Median $38.02 Typical High $38.02 | Professional | None | $33.88 | $38.02 | $38.02 |
United Setting Facility Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,288.25 | Facility | None | $891.25 | $1,047.13 | $1,288.25 |
United Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $57.54 | Professional | None | $31.62 | $38.02 | $57.54 |
Univera Setting Facility Modifier None Typical Low $20.89 Median $36.31 Typical High $51.29 | Facility | None | $20.89 | $36.31 | $51.29 |
Univera Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $39.81 | Professional | None | $16.60 | $31.62 | $39.81 |
10 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 52 · Reduced service Typical Low $17.38 Median $17.78 Typical High $20.89 | Facility | 52 · Reduced service | $17.38 | $17.78 | $20.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $8.32 | Facility | 53 · Discontinued | $7.08 | $7.08 | $8.32 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $46.77 Median $47.86 Typical High $52.48 | Facility | AF · Specialist physician | $46.77 | $47.86 | $52.48 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $34.67 Median $35.48 Typical High $38.90 | Facility | HO · Master's level | $34.67 | $35.48 | $38.90 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $39.81 Median $40.74 Typical High $43.65 | Facility | TD · Registered nurse | $39.81 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | 52 · Reduced service | $17.38 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.94 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | AF · Specialist physician | $45.71 | $47.86 | $50.12 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $33.88 Median $35.48 Typical High $38.02 | Professional | HO · Master's level | $33.88 | $35.48 | $38.02 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $38.90 Median $40.74 Typical High $42.66 | Professional | TD · Registered nurse | $38.90 | $40.74 | $42.66 |
Where New York sits
The same service costs 2.1 times more in North Dakota 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· 26th of 51
$36.31
ND $54.95OH $26.30
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.