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 $112.20 Median $112.20 Typical High $162.18 | Facility | None | $112.20 | $112.20 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $162.18 | Professional | None | $112.20 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $66.07 Typical High $81.28 | Professional | 52 · Reduced service | $56.23 | $66.07 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $251.19 | Professional | None | $151.36 | $190.55 | $251.19 |
United Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $288.40 | Professional | None | $102.33 | $151.36 | $288.40 |
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 25 · Same-day visit + 59 · Distinct service + GC · Resident with teaching physician + SA · Nurse practitioner Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 25 · Same-day visit + 59 · Distinct service + GC · Resident with teaching physician + SA · Nurse practitioner | $234.42 | $234.42 | $234.42 |
Where Delaware sits
The same service costs 2.8 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.
Delaware· 33rd of 51
$162
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.