How much rates vary
Facilitymedian $91 · 10th to 90th $47 to $269Professionalmedian $105 · 10th to 90th $65 to $138
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 $107.15 Typical High $245.47 | Facility | None | $70.79 | $107.15 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $134.90 | Professional | None | $70.79 | $104.71 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $134.90 | Professional | None | $102.33 | $120.23 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $123.03 | Professional | None | $93.33 | $112.20 | $123.03 |
CDPHP Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $186.21 | Professional | None | $66.07 | $93.33 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $83.18 Typical High $269.15 | Facility | None | $0.10 | $83.18 | $269.15 |
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $128.82 | Professional | None | $89.13 | $107.15 | $128.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $208.93 | Facility | None | $25.12 | $25.12 | $208.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $281.84 | Professional | None | $162.18 | $169.82 | $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 $64.57 Median $64.57 Typical High $162.18 | Professional | None | $64.57 | $64.57 | $162.18 |
Optum Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $134.90 | Professional | None | $109.65 | $131.83 | $134.90 |
United Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $147.91 | Professional | None | $67.61 | $97.72 | $147.91 |
Univera Setting Facility Modifier None Typical Low $46.77 Median $77.62 Typical High $489.78 | Facility | None | $46.77 | $77.62 | $489.78 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $128.82 | Professional | None | $89.13 | $104.71 | $128.82 |
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 $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $10.23 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.08 | $10.23 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $120.23 Typical High $128.82 | Professional | 25 · Same-day visit | $100.00 | $120.23 | $128.82 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $141.25 Median $165.96 Typical High $281.84 | Professional | 25 · Same-day visit | $141.25 | $165.96 | $281.84 |
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
$105
AK $229DC $81.28
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.