How much rates vary
Facilitymedian $5 · 10th to 90th $0 to $40Professionalmedian $4 · 10th to 90th $3 to $5
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 $4.79 Median $6.17 Typical High $74.13 | Facility | None | $4.79 | $6.17 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.90 Typical High $5.37 | Professional | None | $4.79 | $4.90 | $5.37 |
Ambetter Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $5.75 | Professional | None | $3.80 | $4.90 | $5.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.31 Median $4.07 Typical High $4.57 | Professional | None | $3.31 | $4.07 | $4.57 |
CDPHP Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $35.48 Typical High $407.38 | Facility | None | $7.76 | $35.48 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $5.01 Typical High $7.08 | Professional | None | $3.09 | $5.01 | $7.08 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $6.03 Typical High $13.80 | Facility | None | $0.10 | $6.03 | $13.80 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | None | $4.27 | $4.27 | $5.62 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $4.90 | Facility | None | $2.69 | $2.69 | $4.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.14 Median $3.98 Typical High $5.25 | Professional | None | $2.14 | $3.98 | $5.25 |
Fidelis Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | None | $4.68 | $4.68 | $4.68 |
Highmark BCBS Setting Facility Modifier None Typical Low $4.68 Median $20.42 Typical High $151.36 | Facility | None | $4.68 | $20.42 | $151.36 |
Highmark BCBS Setting Professional Modifier None Typical Low $6.46 Median $10.96 Typical High $11.22 | Professional | None | $6.46 | $10.96 | $11.22 |
MVP Health Care Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | None | $11.22 | $12.02 | $12.02 |
Optum Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $107.15 | Facility | None | $75.86 | $87.10 | $107.15 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.37 Typical High $10.96 | Professional | None | $4.17 | $5.37 | $10.96 |
Univera Setting Facility Modifier None Typical Low $2.69 Median $4.90 Typical High $9.55 | Facility | None | $2.69 | $4.90 | $9.55 |
Univera Setting Professional Modifier None Typical Low $2.14 Median $4.37 Typical High $5.25 | Professional | None | $2.14 | $4.37 | $5.25 |
8 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 $2.40 Median $2.45 Typical High $2.69 | Professional | 52 · Reduced service | $2.40 | $2.45 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $1.00 Typical High $1.07 | Professional | 53 · Discontinued | $0.98 | $1.00 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.74 Typical High $0.81 | Professional | 55 · Aftercare only | $0.72 | $0.74 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.49 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.48 | $0.49 | $0.54 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $4.17 Median $5.01 Typical High $5.75 | Professional | 59 · Distinct service | $4.17 | $5.01 | $5.75 |
Emblem Health Setting Facility Modifier 59 · Distinct service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | 59 · Distinct service | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier U6 · State-defined Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | U6 · State-defined | $0.10 | $0.10 | $0.10 |
Emblem Health Setting Facility Modifier XU · Unusual separate service Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | XU · Unusual separate service | $0.10 | $0.10 | $0.10 |
Where New York sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 46th of 51
$4.27
ND $8.71NM $3.24
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.