How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $4.79 Typical High $12.30 | Facility | None | $4.79 | $4.79 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $12.02 | Professional | None | $4.79 | $4.79 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $398.11 | Professional | None | $309.03 | $363.08 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $15.49 | Facility | None | $8.13 | $8.13 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Excellus BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Highmark BCBS Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $5.37 Median $8.51 Typical High $9.33 | Professional | None | $5.37 | $8.51 | $9.33 |
Univera Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $1,513.56 | Facility | None | $25.12 | $25.12 | $1,513.56 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
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 $2.40 Median $2.40 Typical High $6.03 | Professional | 52 · Reduced service | $2.40 | $2.40 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $2.45 | Professional | 53 · Discontinued | $0.95 | $0.95 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $1.82 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $1.20 |
Where New York sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 1st of 51
$324
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.