How much rates vary
Facilitymedian $71 · 10th to 90th $30 to $295Professionalmedian $89 · 10th to 90th $48 to $141
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 $60.26 Median $95.50 Typical High $346.74 | Facility | None | $60.26 | $95.50 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $134.90 | Professional | None | $60.26 | $95.50 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $144.54 | Professional | None | $109.65 | $120.23 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $165.96 | Professional | None | $54.95 | $95.50 | $165.96 |
CDPHP Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $177.83 | Professional | None | $109.65 | $109.65 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $134.90 | Professional | None | $45.71 | $60.26 | $134.90 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $69.18 Typical High $229.09 | Facility | None | $39.81 | $69.18 | $229.09 |
Emblem Health Setting Professional Modifier None Typical Low $21.38 Median $39.81 Typical High $75.86 | Professional | None | $21.38 | $39.81 | $75.86 |
Excellus BCBS Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $141.25 | Professional | None | $97.72 | $104.71 | $141.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $173.78 | Professional | None | $125.89 | $128.82 | $173.78 |
MVP Health Care Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
MVP Health Care Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $154.88 | Professional | None | $70.79 | $70.79 | $154.88 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $117.49 | Professional | None | $41.69 | $72.44 | $117.49 |
Univera Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $165.96 | Facility | None | $30.20 | $30.20 | $165.96 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $141.25 | Professional | None | $97.72 | $112.20 | $141.25 |
6 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 $30.20 Median $46.77 Typical High $67.61 | Professional | 52 · Reduced service | $30.20 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $14.13 Typical High $19.95 | Professional | 55 · Aftercare only | $9.12 | $14.13 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $9.33 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.03 | $9.33 | $13.49 |
Fidelis Setting Professional Modifier 25 · Same-day visit Typical Low $102.33 Median $154.88 Typical High $154.88 | Professional | 25 · Same-day visit | $102.33 | $154.88 | $154.88 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $125.89 Typical High $169.82 | Professional | 25 · Same-day visit | $123.03 | $125.89 | $169.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $61.66 | $72.44 | $87.10 |
Where New York sits
The same service costs 4.3 times more in Alaska 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.
New York· 30th of 51
$89.13
AK $263NC $61.66
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.