How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $14.45 Median $15.85 Typical High $52.48 | Facility | None | $14.45 | $15.85 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $21.38 Typical High $29.51 | Professional | None | $14.79 | $21.38 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $22.91 Typical High $74.13 | Professional | None | $12.59 | $22.91 | $74.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $213.80 | Facility | None | $204.17 | $204.17 | $213.80 |
United Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $25.70 | Professional | None | $18.20 | $20.42 | $25.70 |
1 more rate 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Professional Modifier 59 · Distinct service + GC · Resident with teaching physician + HO · Master's level + SA · Nurse practitioner Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 59 · Distinct service + GC · Resident with teaching physician + HO · Master's level + SA · Nurse practitioner | $15.14 | $15.14 | $15.14 |
Where Delaware sits
The same service costs 7.4 times more in Vermont than in New York. 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.
Delaware· 34th of 51
$22.91
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.