How much rates vary
Facilitymedian $33 · 10th to 90th $0 to $871Professionalmedian $52 · 10th to 90th $25 to $68
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 $29.51 Median $269.15 Typical High $295.12 | Facility | None | $29.51 | $269.15 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $46.77 | Professional | None | $28.18 | $30.90 | $46.77 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $67.61 | Professional | None | $48.98 | $56.23 | $67.61 |
CDPHP Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | None | $34.67 | $34.67 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $269.15 Typical High $269.15 | Facility | None | $35.48 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $56.23 | Professional | None | $17.78 | $21.88 | $56.23 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $28.18 Typical High $954.99 | Facility | None | $0.10 | $28.18 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $54.95 | Professional | None | $34.67 | $34.67 | $54.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.75 Median $22.91 Typical High $43.65 | Professional | None | $11.75 | $22.91 | $43.65 |
MVP Health Care Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
MVP Health Care Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $64.57 | Professional | None | $40.74 | $40.74 | $64.57 |
Optum Setting Professional Modifier None Typical Low $23.44 Median $26.92 Typical High $31.62 | Professional | None | $23.44 | $26.92 | $31.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $56.23 | Professional | None | $18.20 | $25.70 | $56.23 |
Univera Setting Facility Modifier None Typical Low $21.88 Median $23.44 Typical High $41.69 | Facility | None | $21.88 | $23.44 | $41.69 |
Univera Setting Professional Modifier None Typical Low $11.75 Median $21.88 Typical High $38.90 | Professional | None | $11.75 | $21.88 | $38.90 |
7 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 $14.13 Median $15.49 Typical High $23.44 | Professional | 52 · Reduced service | $14.13 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.17 Typical High $9.33 | Professional | 53 · Discontinued | $5.62 | $6.17 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.68 Typical High $7.08 | Professional | 55 · Aftercare only | $4.27 | $4.68 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.09 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.82 | $3.09 | $4.68 |
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 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 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 |
Where New York sits
The same service costs 2.8 times more in New York than in Georgia. 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· 1st of 51
$52.48
NY $52.48GA $18.62
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.