How much rates vary
Facilitymedian $72 · 10th to 90th $0 to $95Professionalmedian $38 · 10th to 90th $11 to $47
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 $10.72 Median $10.72 Typical High $16.60 | Facility | None | $10.72 | $10.72 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $14.79 | Professional | None | $10.72 | $10.72 | $14.79 |
Ambetter Setting Professional Modifier None Typical Low $3.24 Median $9.12 Typical High $14.45 | Professional | None | $3.24 | $9.12 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $44.67 | Professional | None | $32.36 | $38.90 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | None | $0.10 | $0.10 | $0.10 |
Excellus BCBS Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $95.50 | Facility | None | $72.44 | $89.13 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $46.77 Median $109.65 Typical High $117.49 | Professional | None | $46.77 | $109.65 | $117.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $66.07 Median $67.61 Typical High $208.93 | Facility | None | $66.07 | $67.61 | $208.93 |
MVP Health Care Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Optum Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $28.18 | Professional | None | $15.14 | $15.14 | $28.18 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $22.91 | Professional | None | $15.14 | $15.14 | $22.91 |
Univera Setting Facility Modifier None Typical Low $69.18 Median $91.20 Typical High $102.33 | Facility | None | $69.18 | $91.20 | $102.33 |
Univera Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $117.49 | Professional | None | $46.77 | $89.13 | $117.49 |
8 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 |
|---|---|---|---|---|---|
Emblem Health Setting Facility Modifier 59 · Distinct service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 59 · Distinct service | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier AF · Specialist physician Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | AF · Specialist physician | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier AG · Primary physician Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | AG · Primary physician | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier HF · Substance use program Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | HF · Substance use program | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier HG · Opioid treatment program Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | HG · Opioid treatment program | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier SA · Nurse practitioner Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | SA · Nurse practitioner | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U4 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U4 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U5 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U5 · State-defined | $0.10 | $0.10 | $0.10 |
Where New York sits
The same service costs 8.7 times more in Montana than in California. 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· 3rd of 51
$38.02
MT $79.43CA $9.12
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.