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 $3.02 Median $3.98 Typical High $26.92 | Facility | None | $3.02 | $3.98 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $29.51 | Professional | None | $3.02 | $3.98 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $28.84 | Professional | None | $14.45 | $17.38 | $28.84 |
CDPHP Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $19.95 Typical High $83.18 | Professional | None | $15.14 | $19.95 | $83.18 |
Emblem Health Setting Facility Modifier None Typical Low $5.01 Median $20.42 Typical High $134.90 | Facility | None | $5.01 | $20.42 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $8.51 Median $10.00 Typical High $31.62 | Professional | None | $8.51 | $10.00 | $31.62 |
Excellus BCBS Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $16.60 | Facility | None | $15.85 | $15.85 | $16.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.88 Median $15.85 Typical High $18.20 | Professional | None | $12.88 | $15.85 | $18.20 |
Highmark BCBS Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $186.21 | Facility | None | $46.77 | $46.77 | $186.21 |
MVP Health Care Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $29.51 Typical High $45.71 | Professional | None | $3.98 | $29.51 | $45.71 |
United Setting Facility Modifier None Typical Low $144.54 Median $169.82 Typical High $208.93 | Facility | None | $144.54 | $169.82 | $208.93 |
United Setting Professional Modifier None Typical Low $11.75 Median $17.38 Typical High $46.77 | Professional | None | $11.75 | $17.38 | $46.77 |
Univera Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $19.05 | Facility | None | $15.85 | $15.85 | $19.05 |
Univera Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $22.91 | Professional | None | $12.88 | $16.60 | $22.91 |
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 $1.51 Median $2.00 Typical High $2.00 | Professional | 52 · Reduced service | $1.51 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.79 Typical High $0.79 | Professional | 53 · Discontinued | $0.60 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.60 Typical High $0.60 | Professional | 55 · Aftercare only | $0.45 | $0.60 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.30 | $0.40 | $0.40 |
Where New York sits
The same service costs 5.2 times more in Texas 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· 32nd 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.