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 $28.18 Median $38.90 Typical High $89.13 | Facility | None | $28.18 | $38.90 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $63.10 | Professional | None | $34.67 | $39.81 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $35.48 Typical High $38.90 | Professional | None | $29.51 | $35.48 | $38.90 |
CDPHP Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $63.10 Typical High $63.10 | Facility | None | $40.74 | $63.10 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $40.74 | Professional | None | $32.36 | $38.02 | $40.74 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $44.67 Typical High $158.49 | Facility | None | $7.08 | $44.67 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $64.57 | Professional | None | $48.98 | $48.98 | $64.57 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Facility | None | $5.01 | $5.01 | $5.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $26.30 Median $26.92 Typical High $42.66 | Professional | None | $26.30 | $26.92 | $42.66 |
Highmark BCBS Setting Facility Modifier None Typical Low $52.48 Median $239.88 Typical High $363.08 | Facility | None | $52.48 | $239.88 | $363.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $61.66 | Professional | None | $34.67 | $36.31 | $61.66 |
MVP Health Care Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
MVP Health Care Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $42.66 | Professional | None | $25.12 | $25.12 | $42.66 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $21.88 Median $30.90 Typical High $37.15 | Professional | None | $21.88 | $30.90 | $37.15 |
Univera Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $67.61 | Facility | None | $5.01 | $5.01 | $67.61 |
Univera Setting Professional Modifier None Typical Low $26.92 Median $30.20 Typical High $39.81 | Professional | None | $26.92 | $30.20 | $39.81 |
3 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 $14.13 Median $14.13 Typical High $18.20 | Professional | 52 · Reduced service | $14.13 | $14.13 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $7.41 | Professional | 53 · Discontinued | $5.62 | $5.62 | $7.41 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $28.84 Typical High $38.90 | Professional | 53 · Discontinued | $15.14 | $28.84 | $38.90 |
Where New York sits
The same service costs 2.9 times more in North Dakota 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
$33.11
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.