How much rates vary
Facilitymedian $89 · 10th to 90th $48 to $324Professionalmedian $100 · 10th to 90th $55 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 $66.07 Median $95.50 Typical High $309.03 | Facility | None | $66.07 | $95.50 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $141.25 | Professional | None | $66.07 | $89.13 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $141.25 | Professional | None | $74.13 | $120.23 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $125.89 | Professional | None | $93.33 | $112.20 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None | $125.89 | $125.89 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $186.21 | Professional | None | $67.61 | $91.20 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $83.18 Typical High $363.08 | Facility | None | $0.10 | $83.18 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $54.95 | Professional | None | $30.90 | $46.77 | $54.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $138.04 | Professional | None | $83.18 | $100.00 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $25.70 Median $67.61 Typical High $83.18 | Facility | None | $25.70 | $67.61 | $83.18 |
Highmark BCBS Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $218.78 | Professional | None | $131.83 | $151.36 | $218.78 |
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 $54.95 Median $54.95 Typical High $162.18 | Professional | None | $54.95 | $54.95 | $162.18 |
United Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $144.54 | Professional | None | $69.18 | $95.50 | $144.54 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $81.28 Typical High $426.58 | Facility | None | $47.86 | $81.28 | $426.58 |
Univera Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $138.04 | Professional | None | $83.18 | $100.00 | $138.04 |
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 $33.11 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $33.11 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $10.00 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.61 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $100.00 Median $117.49 Typical High $134.90 | Professional | 25 · Same-day visit | $100.00 | $117.49 | $134.90 |
Fidelis Setting Professional Modifier 25 · Same-day visit Typical Low $97.72 Median $107.15 Typical High $144.54 | Professional | 25 · Same-day visit | $97.72 | $107.15 | $144.54 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $154.88 Typical High $165.96 | Professional | 25 · Same-day visit | $131.83 | $154.88 | $165.96 |
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· 36th of 51
$100
AK $224DC $83.18
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.