How much rates vary
Facilitymedian $158 · 10th to 90th $69 to $398Professionalmedian $138 · 10th to 90th $100 to $195
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 $131.83 Median $181.97 Typical High $446.68 | Facility | None | $131.83 | $181.97 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $181.97 | Professional | None | $128.82 | $154.88 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $223.87 | Professional | None | $134.90 | $173.78 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $141.25 | Professional | None | $93.33 | $117.49 | $141.25 |
CDPHP Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $281.84 | Professional | None | $190.55 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $275.42 | Facility | None | $109.65 | $199.53 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $112.20 Typical High $177.83 | Professional | None | $60.26 | $112.20 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $144.54 Typical High $398.11 | Facility | None | $0.10 | $144.54 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | None | $100.00 | $144.54 | $199.53 |
Excellus BCBS Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $151.36 | Facility | None | $72.44 | $138.04 | $151.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $208.93 | Professional | None | $91.20 | $173.78 | $208.93 |
Fidelis Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $199.53 | Professional | None | $81.28 | $81.28 | $199.53 |
Highmark BCBS Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $575.44 | Facility | None | $199.53 | $234.42 | $575.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $223.87 | Professional | None | $169.82 | $213.80 | $223.87 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $1,479.11 | Facility | None | $251.19 | $251.19 | $1,479.11 |
MVP Health Care Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $204.17 | Professional | None | $109.65 | $109.65 | $204.17 |
Optum Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $213.80 | Professional | None | $147.91 | $162.18 | $213.80 |
United Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $512.86 | Facility | None | $354.81 | $416.87 | $512.86 |
United Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $213.80 | Professional | None | $131.83 | $162.18 | $213.80 |
Univera Setting Facility Modifier None Typical Low $69.18 Median $144.54 Typical High $208.93 | Facility | None | $69.18 | $144.54 | $208.93 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $169.82 Typical High $208.93 | Professional | None | $91.20 | $169.82 | $208.93 |
20 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 AF · Specialist physician Typical Low $165.96 Median $181.97 Typical High $218.78 | Facility | AF · Specialist physician | $165.96 | $181.97 | $218.78 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $123.03 Median $138.04 Typical High $147.91 | Facility | HO · Master's level | $123.03 | $138.04 | $147.91 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $141.25 Median $154.88 Typical High $169.82 | Facility | TD · Registered nurse | $141.25 | $154.88 | $169.82 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $128.82 Median $144.54 Typical High $190.55 | Professional | AF · Specialist physician | $128.82 | $144.54 | $190.55 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $123.03 Median $138.04 Typical High $147.91 | Professional | HO · Master's level | $123.03 | $138.04 | $147.91 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $64.57 Median $89.13 Typical High $162.18 | Professional | TD · Registered nurse | $64.57 | $89.13 | $162.18 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | SA · Nurse practitioner | $138.04 | $144.54 | $169.82 |
Emblem Health Setting Facility Modifier 59 · Distinct service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 59 · Distinct service | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier AF · Specialist physician Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | AF · Specialist physician | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier AG · Primary physician Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | AG · Primary physician | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier HE · Mental health program Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | HE · Mental health program | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier HF · Substance use program Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | HF · Substance use program | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier HG · Opioid treatment program Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | HG · Opioid treatment program | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier HO · Master's level Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | HO · Master's level | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier SA · Nurse practitioner Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | SA · Nurse practitioner | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U4 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U4 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U5 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U5 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U6 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U6 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier XP · Separate practitioner Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | XP · Separate practitioner | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | HG · Opioid treatment program | $144.54 | $144.54 | $144.54 |
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· 49th of 51
$138
ND $295KY $132
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.