How much rates vary
Facilitymedian $72 · 10th to 90th $36 to $224Professionalmedian $68 · 10th to 90th $48 to $83
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 $63.10 Median $79.43 Typical High $223.87 | Facility | None | $63.10 | $79.43 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $89.13 | Professional | None | $63.10 | $74.13 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $93.33 | Professional | None | $51.29 | $69.18 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $83.18 | Professional | None | $58.88 | $69.18 | $83.18 |
CDPHP Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $109.65 | Professional | None | $85.11 | $87.10 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $117.49 Typical High $269.15 | Facility | None | $60.26 | $117.49 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $77.62 | Professional | None | $39.81 | $48.98 | $77.62 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $54.95 Typical High $169.82 | Facility | None | $0.10 | $54.95 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $46.77 | Professional | None | $38.02 | $44.67 | $46.77 |
Excellus BCBS Setting Facility Modifier None Typical Low $36.31 Median $58.88 Typical High $64.57 | Facility | None | $36.31 | $58.88 | $64.57 |
Excellus BCBS Setting Professional Modifier None Typical Low $35.48 Median $72.44 Typical High $89.13 | Professional | None | $35.48 | $72.44 | $89.13 |
Fidelis Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $75.86 | Professional | None | $39.81 | $70.79 | $75.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $263.03 | Facility | None | $67.61 | $112.20 | $263.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $66.07 Median $70.79 Typical High $93.33 | Professional | None | $66.07 | $70.79 | $93.33 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $1,479.11 | Facility | None | $53.70 | $53.70 | $1,479.11 |
MVP Health Care Setting Professional Modifier None Typical Low $25.12 Median $34.67 Typical High $64.57 | Professional | None | $25.12 | $34.67 | $64.57 |
Optum Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $83.18 | Professional | None | $56.23 | $61.66 | $83.18 |
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 $56.23 Median $61.66 Typical High $83.18 | Professional | None | $56.23 | $61.66 | $83.18 |
Univera Setting Facility Modifier None Typical Low $34.67 Median $61.66 Typical High $93.33 | Facility | None | $34.67 | $61.66 | $93.33 |
Univera Setting Professional Modifier None Typical Low $35.48 Median $67.61 Typical High $85.11 | Professional | None | $35.48 | $67.61 | $85.11 |
26 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 $79.43 Median $89.13 Typical High $93.33 | Facility | AF · Specialist physician | $79.43 | $89.13 | $93.33 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $63.10 Median $66.07 Typical High $72.44 | Facility | HO · Master's level | $63.10 | $66.07 | $72.44 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $70.79 Median $74.13 Typical High $81.28 | Facility | TD · Registered nurse | $70.79 | $74.13 | $81.28 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $60.26 Median $79.43 Typical High $89.13 | Professional | AF · Specialist physician | $60.26 | $79.43 | $89.13 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $56.23 Median $66.07 Typical High $72.44 | Professional | HO · Master's level | $56.23 | $66.07 | $72.44 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $64.57 Median $74.13 Typical High $83.18 | Professional | TD · Registered nurse | $64.57 | $74.13 | $83.18 |
Emblem Health Setting Facility Modifier 25 · Same-day visit Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 25 · Same-day visit | $0.10 | $0.10 | $0.10 |
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 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 TL · Early intervention Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | TL · Early intervention | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U1 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U1 · State-defined | $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 U9 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U9 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier XE · Separate encounter Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | XE · Separate encounter | $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 Facility Modifier XU · Unusual separate service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | XU · Unusual separate service | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Professional Modifier HF · Substance use program Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | HF · Substance use program | $38.02 | $38.02 | $46.77 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $32.36 Median $38.02 Typical High $44.67 | Professional | HG · Opioid treatment program | $32.36 | $38.02 | $44.67 |
Highmark BCBS Setting Professional Modifier 93 · Audio-only telehealth Typical Low $66.07 Median $70.79 Typical High $81.28 | Professional | 93 · Audio-only telehealth | $66.07 | $70.79 | $81.28 |
Where New York sits
The same service costs 1.9 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
$67.61
ND $100KY $53.70
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.