How much rates vary
Facilitymedian $123 · 10th to 90th $69 to $407Professionalmedian $138 · 10th to 90th $85 to $195
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 $95.50 Median $125.89 Typical High $457.09 | Facility | None | $95.50 | $125.89 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $199.53 | Professional | None | $95.50 | $123.03 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $186.21 | Professional | None | $144.54 | $173.78 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $169.82 | Professional | None | $128.82 | $151.36 | $169.82 |
CDPHP Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | None | $177.83 | $177.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $245.47 | Professional | None | $97.72 | $128.82 | $245.47 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $112.20 Typical High $302.00 | Facility | None | $0.10 | $112.20 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $85.11 Typical High $100.00 | Professional | None | $30.90 | $85.11 | $100.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $190.55 | Professional | None | $123.03 | $147.91 | $190.55 |
Highmark BCBS Setting Professional Modifier None Typical Low $173.78 Median $208.93 Typical High $218.78 | Professional | None | $173.78 | $208.93 | $218.78 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $234.42 | Professional | None | $85.11 | $85.11 | $234.42 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $204.17 | Professional | None | $100.00 | $134.90 | $204.17 |
Univera Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $588.84 | Facility | None | $69.18 | $114.82 | $588.84 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $190.55 | Professional | None | $123.03 | $147.91 | $190.55 |
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 $47.86 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $47.86 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $14.45 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $138.04 Median $165.96 Typical High $190.55 | Professional | 25 · Same-day visit | $138.04 | $165.96 | $190.55 |
Highmark BCBS Setting Facility Modifier 25 · Same-day visit Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | 25 · Same-day visit | $38.02 | $38.02 | $38.02 |
Where New York sits
The same service costs 2.6 times more in Alaska than in Florida. 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· 38th of 51
$138
AK $316FL $120
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.