How much rates vary
Facilitymedian $98 · 10th to 90th $52 to $331Professionalmedian $110 · 10th to 90th $72 to $151
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 $72.44 Median $100.00 Typical High $363.08 | Facility | None | $72.44 | $100.00 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $158.49 | Professional | None | $72.44 | $97.72 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $147.91 | Professional | None | $109.65 | $138.04 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $138.04 | Professional | None | $102.33 | $123.03 | $138.04 |
CDPHP Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $204.17 | Professional | None | $75.86 | $104.71 | $204.17 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $87.10 Typical High $302.00 | Facility | None | $0.10 | $87.10 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $57.54 Typical High $57.54 | Professional | None | $30.90 | $57.54 | $57.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $151.36 | Professional | None | $97.72 | $114.82 | $151.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $34.67 Median $123.03 Typical High $158.49 | Facility | None | $34.67 | $123.03 | $158.49 |
Highmark BCBS Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $269.15 | Professional | None | $144.54 | $165.96 | $269.15 |
MVP Health Care Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $177.83 | Professional | None | $75.86 | $75.86 | $177.83 |
Optum Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $147.91 | Professional | None | $120.23 | $141.25 | $147.91 |
United Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $162.18 | Professional | None | $75.86 | $107.15 | $162.18 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $89.13 Typical High $588.84 | Facility | None | $52.48 | $89.13 | $588.84 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $151.36 | Professional | None | $97.72 | $114.82 | $151.36 |
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 $36.31 Median $48.98 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $11.48 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $112.20 Median $131.83 Typical High $147.91 | Professional | 25 · Same-day visit | $112.20 | $131.83 | $147.91 |
Fidelis Setting Professional Modifier 25 · Same-day visit Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 25 · Same-day visit | $144.54 | $158.49 | $158.49 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $144.54 Median $173.78 Typical High $229.09 | Professional | 25 · Same-day visit | $144.54 | $173.78 | $229.09 |
Where New York sits
The same service costs 2.7 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· 41st of 51
$110
AK $251DC $93.33
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.