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 $11.22 Typical High $35.48 | Facility | None | $10.00 | $11.22 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $26.92 | Professional | None | $10.00 | $10.96 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $13.18 Typical High $20.42 | Professional | None | $10.72 | $13.18 | $20.42 |
CDPHP Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $15.49 Typical High $77.62 | Professional | None | $11.75 | $15.49 | $77.62 |
Emblem Health Setting Facility Modifier None Typical Low $5.01 Median $19.50 Typical High $63.10 | Facility | None | $5.01 | $19.50 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $4.68 Median $5.50 Typical High $29.51 | Professional | None | $4.68 | $5.50 | $29.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $14.79 | Facility | None | $13.80 | $13.80 | $14.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.55 Median $13.80 Typical High $16.22 | Professional | None | $9.55 | $13.80 | $16.22 |
Highmark BCBS Setting Facility Modifier None Typical Low $14.13 Median $35.48 Typical High $63.10 | Facility | None | $14.13 | $35.48 | $63.10 |
Highmark BCBS Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $35.48 | Professional | None | $34.67 | $34.67 | $35.48 |
MVP Health Care Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
MVP Health Care Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $30.90 | Professional | None | $14.13 | $16.60 | $30.90 |
United Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $37.15 | Professional | None | $10.72 | $15.49 | $37.15 |
Univera Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $16.60 | Facility | None | $13.80 | $13.80 | $16.60 |
Univera Setting Professional Modifier None Typical Low $9.55 Median $14.79 Typical High $17.38 | Professional | None | $9.55 | $14.79 | $17.38 |
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 $5.01 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.01 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.00 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.51 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.10 |
Where New York sits
The same service costs 5.6 times more in Alabama than in Kentucky. 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· 34th of 51
$13.49
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.