How much rates vary
Facilitymedian $13 · 10th to 90th $7 to $47Professionalmedian $16 · 10th to 90th $7 to $69
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 $9.33 Median $12.88 Typical High $38.90 | Facility | None | $9.33 | $12.88 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $10.72 Typical High $18.20 | Professional | None | $9.33 | $10.72 | $18.20 |
Ambetter Setting Professional Modifier None Typical Low $10.72 Median $14.79 Typical High $17.38 | Professional | None | $10.72 | $14.79 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.98 Median $58.88 Typical High $72.44 | Professional | None | $0.98 | $58.88 | $72.44 |
CDPHP Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $21.88 | Professional | None | $17.38 | $17.38 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $12.02 Typical High $23.44 | Professional | None | $9.33 | $12.02 | $23.44 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $12.88 Typical High $39.81 | Facility | None | $0.10 | $12.88 | $39.81 |
Emblem Health Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $23.44 | Professional | None | $10.00 | $13.49 | $23.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $20.89 | Professional | None | $11.48 | $14.79 | $20.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $19.05 Median $29.51 Typical High $52.48 | Facility | None | $19.05 | $29.51 | $52.48 |
Highmark BCBS Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $36.31 | Professional | None | $14.13 | $19.05 | $36.31 |
MVP Health Care Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
MVP Health Care Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $20.42 | Professional | None | $9.77 | $9.77 | $20.42 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $107.15 | Facility | None | $75.86 | $87.10 | $107.15 |
United Setting Professional Modifier None Typical Low $8.91 Median $12.88 Typical High $18.62 | Professional | None | $8.91 | $12.88 | $18.62 |
Univera Setting Facility Modifier None Typical Low $6.03 Median $10.96 Typical High $45.71 | Facility | None | $6.03 | $10.96 | $45.71 |
Univera Setting Professional Modifier None Typical Low $11.48 Median $14.45 Typical High $20.89 | Professional | None | $11.48 | $14.45 | $20.89 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $10.47 Median $12.59 Typical High $15.85 | Professional | 25 · Same-day visit | $10.47 | $12.59 | $15.85 |
Emblem Health Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | GQ · Store-and-forward telehealth | $10.23 | $10.23 | $10.23 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | HG · Opioid treatment program | $10.00 | $10.00 | $10.00 |
Fidelis Setting Professional Modifier 25 · Same-day visit Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 25 · Same-day visit | $14.13 | $14.13 | $14.13 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit Typical Low $13.49 Median $19.50 Typical High $19.95 | Professional | 25 · Same-day visit | $13.49 | $19.50 | $19.95 |
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· 21st of 51
$15.85
AK $31.62DC $11.48
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.