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 $10.00 Median $17.78 Typical High $40.74 | Facility | None | $10.00 | $17.78 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $17.78 Typical High $26.30 | Professional | None | $10.00 | $17.78 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $17.78 Typical High $32.36 | Professional | None | $14.79 | $17.78 | $32.36 |
CDPHP Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $24.55 | Professional | None | $13.18 | $13.18 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $12.88 Typical High $28.18 | Facility | None | $8.51 | $12.88 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $19.50 Typical High $44.67 | Professional | None | $11.75 | $19.50 | $44.67 |
Emblem Health Setting Facility Modifier None Typical Low $9.33 Median $15.85 Typical High $33.11 | Facility | None | $9.33 | $15.85 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $5.75 | Professional | None | $4.27 | $5.01 | $5.75 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $26.30 | Professional | None | $12.02 | $18.20 | $26.30 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $8.13 Median $8.91 Typical High $11.75 | Facility | None | $8.13 | $8.91 | $11.75 |
MVP Health Care Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $42.66 | Professional | None | $16.98 | $16.98 | $42.66 |
United Setting Professional Modifier None Typical Low $8.32 Median $16.60 Typical High $36.31 | Professional | None | $8.32 | $16.60 | $36.31 |
Univera Setting Facility Modifier None Typical Low $6.46 Median $11.75 Typical High $35.48 | Facility | None | $6.46 | $11.75 | $35.48 |
Univera Setting Professional Modifier None Typical Low $10.96 Median $18.20 Typical High $26.30 | Professional | None | $10.96 | $18.20 | $26.30 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.01 Median $8.91 Typical High $11.75 | Professional | 52 · Reduced service | $5.01 | $8.91 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $3.63 Typical High $4.79 | Professional | 53 · Discontinued | $2.00 | $3.63 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $2.69 Typical High $3.55 | Professional | 55 · Aftercare only | $1.51 | $2.69 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.82 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.00 | $1.82 | $2.34 |
Highmark BCBS Setting Professional Modifier XU · Unusual separate service Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | XU · Unusual separate service | $10.72 | $10.72 | $10.72 |
Where New York sits
The same service costs 3.1 times more in Wisconsin 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· 40th 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.