How much rates vary
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 $5.75 Median $8.71 Typical High $14.79 | Facility | None | $5.75 | $8.71 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $10.96 Typical High $17.38 | Professional | None | $5.75 | $10.96 | $17.38 |
Ambetter Setting Professional Modifier None Typical Low $10.00 Median $18.20 Typical High $19.05 | Professional | None | $10.00 | $18.20 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $22.39 | Professional | None | $16.98 | $19.95 | $22.39 |
CDPHP Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $26.30 | Professional | None | $13.18 | $13.18 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Emblem Health Setting Facility Modifier None Typical Low $8.51 Median $10.23 Typical High $30.90 | Facility | None | $8.51 | $10.23 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $37.15 | Professional | None | $22.39 | $22.39 | $37.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.79 Median $16.60 Typical High $19.05 | Professional | None | $14.79 | $16.60 | $19.05 |
Highmark BCBS Setting Professional Modifier None Typical Low $15.14 Median $19.05 Typical High $29.51 | Professional | None | $15.14 | $19.05 | $29.51 |
MVP Health Care Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $24.55 | Professional | None | $16.60 | $16.60 | $24.55 |
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 $7.24 Median $13.49 Typical High $21.38 | Professional | None | $7.24 | $13.49 | $21.38 |
Univera Setting Facility Modifier None Typical Low $9.12 Median $9.77 Typical High $9.77 | Facility | None | $9.12 | $9.77 | $9.77 |
Univera Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $19.05 | Professional | None | $12.02 | $15.14 | $19.05 |
4 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 $2.82 Median $5.50 Typical High $7.41 | Professional | 52 · Reduced service | $2.82 | $5.50 | $7.41 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $15.49 Median $19.05 Typical High $25.12 | Professional | 59 · Distinct service | $15.49 | $19.05 | $25.12 |
Emblem Health Setting Professional Modifier GQ · Store-and-forward telehealth Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | GQ · Store-and-forward telehealth | $3.24 | $3.24 | $3.24 |
Fidelis Setting Professional Modifier XU · Unusual separate service Typical Low $16.98 Median $22.91 Typical High $22.91 | Professional | XU · Unusual separate service | $16.98 | $22.91 | $22.91 |
Where New York sits
The same service costs 2.3 times more in Alaska than in Louisiana. 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· 14th of 51
$17.38
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.