How much rates vary
Professionalmedian $21 · 10th to 90th $18 to $35
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 Professional Modifier None (both parts) Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None (both parts) | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 26 · Professional part | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | TC · Technical part | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $14.13 Median $32.36 Typical High $48.98 | Professional | None (both parts) | $14.13 | $32.36 | $48.98 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $7.94 Median $11.48 Typical High $17.78 | Professional | 26 · Professional part | $7.94 | $11.48 | $17.78 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $10.96 Median $18.20 Typical High $25.70 | Professional | TC · Technical part | $10.96 | $18.20 | $25.70 |
Cigna Setting Professional Modifier None (both parts) Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None (both parts) | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 26 · Professional part | $7.41 | $7.41 | $7.41 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | TC · Technical part | $10.23 | $10.23 | $10.23 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $23.44 Median $23.44 Typical High $29.51 | Professional | None (both parts) | $23.44 | $23.44 | $29.51 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $10.00 Median $10.00 Typical High $13.49 | Professional | 26 · Professional part | $10.00 | $10.00 | $13.49 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $13.18 Median $13.80 Typical High $16.60 | Professional | TC · Technical part | $13.18 | $13.80 | $16.60 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None (both parts) | $20.89 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 26 · Professional part | $9.55 | $9.55 | $9.55 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | TC · Technical part | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None (both parts) Typical Low $17.78 Median $28.18 Typical High $35.48 | Professional | None (both parts) | $17.78 | $28.18 | $35.48 |
United Setting Professional Modifier 26 · Professional part Typical Low $8.32 Median $12.59 Typical High $16.22 | Professional | 26 · Professional part | $8.32 | $12.59 | $16.22 |
United Setting Professional Modifier TC · Technical part Typical Low $9.33 Median $15.49 Typical High $19.95 | Professional | TC · Technical part | $9.33 | $15.49 | $19.95 |
4 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 Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Where Maine sits
The same service costs 2.3 times more in Wisconsin than in North Carolina. 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.
Maine· 31st of 51
$20.89
WI $39.81NC $17.38
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.