How much rates vary
Facilitymedian $148 · 10th to 90th $87 to $372Professionalmedian $129 · 10th to 90th $91 to $200
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 $100.00 Median $147.91 Typical High $281.84 | Facility | None | $100.00 | $147.91 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $199.53 | Professional | None | $91.20 | $147.91 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $199.53 | Professional | None | $104.71 | $165.96 | $199.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $891.25 Typical High $1,258.93 | Facility | None | $776.25 | $891.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $208.93 | Professional | None | $107.15 | $128.82 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $234.42 | Professional | None | $190.55 | $190.55 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $269.15 | Facility | None | $151.36 | $151.36 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $295.12 | Professional | None | $128.82 | $154.88 | $295.12 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $56.23 Typical High $302.00 | Facility | None | $0.10 | $56.23 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $81.28 Typical High $91.20 | Professional | None | $30.90 | $81.28 | $91.20 |
Excellus BCBS Setting Facility Modifier None Typical Low $36.31 Median $45.71 Typical High $67.61 | Facility | None | $36.31 | $45.71 | $67.61 |
Excellus BCBS Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $186.21 | Professional | None | $109.65 | $144.54 | $186.21 |
Fidelis Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | None | $173.78 | $213.80 | $213.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $263.03 Median $309.03 Typical High $724.44 | Facility | None | $263.03 | $309.03 | $724.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $338.84 | Professional | None | $173.78 | $213.80 | $338.84 |
MVP Health Care Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $239.88 | Facility | None | $123.03 | $123.03 | $239.88 |
MVP Health Care Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $229.09 | Professional | None | $100.00 | $100.00 | $229.09 |
Optum Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $186.21 | Professional | None | $141.25 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $199.53 | Professional | None | $87.10 | $128.82 | $199.53 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $114.82 Typical High $389.05 | Facility | None | $45.71 | $114.82 | $389.05 |
Univera Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $186.21 | Professional | None | $109.65 | $144.54 | $186.21 |
8 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 $45.71 Median $58.88 Typical High $61.66 | Professional | 52 · Reduced service | $45.71 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $17.78 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $12.30 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $125.89 Median $173.78 Typical High $213.80 | Professional | 25 · Same-day visit | $125.89 | $173.78 | $213.80 |
Emblem Health Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | GQ · Store-and-forward telehealth | $112.20 | $120.23 | $120.23 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | HG · Opioid treatment program | $104.71 | $104.71 | $104.71 |
Fidelis Setting Professional Modifier 25 · Same-day visit Typical Low $104.71 Median $144.54 Typical High $213.80 | Professional | 25 · Same-day visit | $104.71 | $144.54 | $213.80 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $165.96 Median $213.80 Typical High $295.12 | Professional | 25 · Same-day visit | $165.96 | $213.80 | $295.12 |
Where New York sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 47th of 51
$129
AK $263AL $115
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.