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 $9.77 Median $10.00 Typical High $83.18 | Facility | None | $9.77 | $10.00 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $10.00 Typical High $46.77 | Professional | None | $9.77 | $10.00 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $31.62 | Professional | None | $14.45 | $17.38 | $31.62 |
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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $165.96 | Professional | None | $29.51 | $29.51 | $165.96 |
Emblem Health Setting Facility Modifier None Typical Low $5.01 Median $37.15 Typical High $131.83 | Facility | None | $5.01 | $37.15 | $131.83 |
Emblem Health Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $112.20 | Professional | None | $39.81 | $63.10 | $112.20 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $13.49 Median $22.91 Typical High $33.11 | Professional | None | $13.49 | $22.91 | $33.11 |
Highmark BCBS Setting Facility Modifier None Typical Low $41.69 Median $63.10 Typical High $91.20 | Facility | None | $41.69 | $63.10 | $91.20 |
Highmark BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $67.61 | Professional | None | $26.92 | $26.92 | $67.61 |
MVP Health Care Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
MVP Health Care Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
United Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $134.90 | Facility | None | $93.33 | $109.65 | $134.90 |
United Setting Professional Modifier None Typical Low $12.88 Median $28.84 Typical High $50.12 | Professional | None | $12.88 | $28.84 | $50.12 |
Univera Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $21.88 | Facility | None | $13.49 | $13.49 | $21.88 |
Univera Setting Professional Modifier None Typical Low $13.49 Median $21.88 Typical High $33.11 | Professional | None | $13.49 | $21.88 | $33.11 |
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 $4.90 Median $4.90 Typical High $5.01 | Professional | 52 · Reduced service | $4.90 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $2.00 | Professional | 53 · Discontinued | $1.95 | $1.95 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.48 Median $1.48 Typical High $1.51 | Professional | 55 · Aftercare only | $1.48 | $1.48 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $0.98 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.98 | $0.98 | $1.00 |
Where New York sits
The same service costs 4.6 times more in Alabama than in Missouri. 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
$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.