How much rates vary
Facilitymedian $2 · 10th to 90th $1 to $7Professionalmedian $2 · 10th to 90th $2 to $3
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 $1.82 Median $2.04 Typical High $2.45 | Facility | None | $1.82 | $2.04 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $2.88 | Professional | None | $2.04 | $2.19 | $2.88 |
Ambetter Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $2.82 | Professional | None | $2.04 | $2.45 | $2.82 |
CDPHP Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
Cigna Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $295.12 | Facility | None | $3.63 | $3.63 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $5.01 Typical High $5.01 | Professional | None | $2.00 | $5.01 | $5.01 |
Emblem Health Setting Facility Modifier None Typical Low $1.78 Median $2.95 Typical High $9.55 | Facility | None | $1.78 | $2.95 | $9.55 |
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 $1.12 Median $1.12 Typical High $2.40 | Facility | None | $1.12 | $1.12 | $2.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.89 Median $1.95 Typical High $2.57 | Professional | None | $0.89 | $1.95 | $2.57 |
Highmark BCBS Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
MVP Health Care Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $3.55 | Professional | None | $2.04 | $2.04 | $3.55 |
Optum Setting Professional Modifier None Typical Low $2.34 Median $2.63 Typical High $2.63 | Professional | None | $2.34 | $2.63 | $2.63 |
United Setting Facility Modifier None Typical Low $57.54 Median $67.61 Typical High $83.18 | Facility | None | $57.54 | $67.61 | $83.18 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.63 Typical High $3.31 | Professional | None | $1.91 | $2.63 | $3.31 |
Univera Setting Facility Modifier None Typical Low $1.12 Median $2.40 Typical High $2.63 | Facility | None | $1.12 | $2.40 | $2.63 |
Univera Setting Professional Modifier None Typical Low $0.89 Median $2.14 Typical High $2.57 | Professional | None | $0.89 | $2.14 | $2.57 |
11 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 $1.02 Median $1.02 Typical High $1.23 | Facility | 52 · Reduced service | $1.02 | $1.02 | $1.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.41 Median $0.41 Typical High $0.48 | Facility | 53 · Discontinued | $0.41 | $0.41 | $0.48 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $2.45 Median $2.88 Typical High $3.09 | Facility | AF · Specialist physician | $2.45 | $2.88 | $3.09 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $1.82 Median $2.19 Typical High $2.29 | Facility | HO · Master's level | $1.82 | $2.19 | $2.29 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $2.04 Median $2.45 Typical High $2.63 | Facility | TD · Registered nurse | $2.04 | $2.45 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.02 Median $1.02 Typical High $1.12 | Professional | 52 · Reduced service | $1.02 | $1.02 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.41 Typical High $0.46 | Professional | 53 · Discontinued | $0.41 | $0.41 | $0.46 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $2.45 Median $2.88 Typical High $3.02 | Professional | AF · Specialist physician | $2.45 | $2.88 | $3.02 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $1.82 Median $2.19 Typical High $2.29 | Professional | HO · Master's level | $1.82 | $2.19 | $2.29 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $2.04 Median $2.45 Typical High $2.57 | Professional | TD · Registered nurse | $2.04 | $2.45 | $2.57 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 59 · Distinct service | $2.04 | $2.04 | $2.04 |
Where New York sits
The same service costs 2.2 times more in North Dakota 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· 22nd of 51
$2.40
ND $3.55KY $1.62
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.