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 $10.47 Median $13.18 Typical High $26.92 | Facility | None | $10.47 | $13.18 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | None | $10.47 | $10.47 | $13.18 |
Ambetter Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $16.22 | Professional | None | $11.48 | $11.48 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $10.47 Typical High $12.30 | Professional | None | $8.71 | $10.47 | $12.30 |
CDPHP Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $12.88 Typical High $28.18 | Professional | None | $8.13 | $12.88 | $28.18 |
Emblem Health Setting Facility Modifier None Typical Low $9.55 Median $13.49 Typical High $44.67 | Facility | None | $9.55 | $13.49 | $44.67 |
Emblem Health Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $25.12 | Professional | None | $13.80 | $17.78 | $25.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.25 Median $9.55 Typical High $14.45 | Professional | None | $5.25 | $9.55 | $14.45 |
MVP Health Care Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $20.89 | Professional | None | $10.23 | $10.23 | $20.89 |
United Setting Professional Modifier None Typical Low $9.33 Median $12.30 Typical High $26.92 | Professional | None | $9.33 | $12.30 | $26.92 |
Univera Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $14.79 | Facility | None | $11.22 | $11.22 | $14.79 |
Univera Setting Professional Modifier None Typical Low $5.25 Median $9.55 Typical High $14.45 | Professional | None | $5.25 | $9.55 | $14.45 |
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 $5.25 Median $5.25 Typical High $6.61 | Professional | 52 · Reduced service | $5.25 | $5.25 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.09 Typical High $2.63 | Professional | 53 · Discontinued | $2.09 | $2.09 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $2.00 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.05 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.05 | $1.05 | $1.32 |
Where New York sits
The same service costs 2.6 times more in Alaska 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· 47th of 51
$10.47
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.