How much rates vary
Facilitymedian $85 · 10th to 90th $59 to $263Professionalmedian $85 · 10th to 90th $47 to $115
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 $58.88 Median $85.11 Typical High $275.42 | Facility | None | $58.88 | $85.11 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $104.71 | Professional | None | $58.88 | $85.11 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $123.03 | Professional | None | $85.11 | $97.72 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | None | $77.62 | $93.33 | $102.33 |
CDPHP Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $141.25 | Professional | None | $97.72 | $97.72 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $151.36 | Professional | None | $53.70 | $77.62 | $151.36 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $223.87 | Facility | None | $60.26 | $74.13 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $47.86 | Professional | None | $30.90 | $42.66 | $47.86 |
Excellus BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $114.82 | Professional | None | $67.61 | $85.11 | $114.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $234.42 | Professional | None | $109.65 | $138.04 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $134.90 | Professional | None | $39.81 | $39.81 | $134.90 |
United Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $123.03 | Professional | None | $52.48 | $79.43 | $123.03 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $63.10 Typical High $281.84 | Facility | None | $37.15 | $63.10 | $281.84 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $114.82 | Professional | None | $67.61 | $85.11 | $114.82 |
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 $29.51 Median $40.74 Typical High $43.65 | Professional | 52 · Reduced service | $29.51 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.02 Typical High $13.18 | Professional | 55 · Aftercare only | $8.91 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.13 Typical High $8.71 | Professional | 56 · Pre-op care only | $5.89 | $8.13 | $8.71 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $85.11 Median $100.00 Typical High $114.82 | Professional | 25 · Same-day visit | $85.11 | $100.00 | $114.82 |
Fidelis Setting Professional Modifier 25 · Same-day visit Typical Low $95.50 Median $95.50 Typical High $102.33 | Professional | 25 · Same-day visit | $95.50 | $95.50 | $102.33 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $117.49 Median $138.04 Typical High $199.53 | Professional | 25 · Same-day visit | $117.49 | $138.04 | $199.53 |
Where New York sits
The same service costs 2.9 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· 31st of 51
$85.11
AK $186DC $64.57
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.