How much rates vary
Facilitymedian $89 · 10th to 90th $44 to $316Professionalmedian $100 · 10th to 90th $60 to $135
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 $70.79 Median $114.82 Typical High $489.78 | Facility | None | $70.79 | $114.82 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $131.83 | Professional | None | $70.79 | $100.00 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $131.83 | Professional | None | $97.72 | $114.82 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | None | $89.13 | $107.15 | $117.49 |
CDPHP Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $162.18 | Professional | None | $114.82 | $114.82 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $177.83 | Professional | None | $61.66 | $89.13 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $79.43 Typical High $251.19 | Facility | None | $0.10 | $79.43 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $53.70 | Professional | None | $30.90 | $51.29 | $53.70 |
Excellus BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $131.83 | Professional | None | $91.20 | $107.15 | $131.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $281.84 | Professional | None | $154.88 | $154.88 | $281.84 |
MVP Health Care Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $158.49 | Professional | None | $60.26 | $60.26 | $158.49 |
United Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $141.25 | Professional | None | $63.10 | $93.33 | $141.25 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $74.13 Typical High $446.68 | Facility | None | $43.65 | $74.13 | $446.68 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $131.83 | Professional | None | $91.20 | $100.00 | $131.83 |
5 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 $35.48 Median $48.98 Typical High $57.54 | Professional | 52 · Reduced service | $35.48 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $10.72 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.77 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.08 | $9.77 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $114.82 Typical High $123.03 | Professional | 25 · Same-day visit | $95.50 | $114.82 | $123.03 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $154.88 Median $158.49 Typical High $234.42 | Professional | 25 · Same-day visit | $154.88 | $158.49 | $234.42 |
Where New York sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 36th of 51
$100
AK $219DC $77.62
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.