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 $21.88 Median $26.92 Typical High $30.90 | Facility | None | $21.88 | $26.92 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $23.99 Typical High $33.11 | Professional | None | $21.88 | $23.99 | $33.11 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $30.20 Typical High $31.62 | Professional | None | $19.95 | $30.20 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $36.31 | Professional | None | $17.78 | $20.89 | $36.31 |
CDPHP Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | None | $39.81 | $39.81 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Emblem Health Setting Facility Modifier None Typical Low $22.91 Median $27.54 Typical High $85.11 | Facility | None | $22.91 | $27.54 | $85.11 |
Emblem Health Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $56.23 | Professional | None | $35.48 | $37.15 | $56.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $40.74 | Professional | None | $25.70 | $30.20 | $40.74 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $43.65 | Professional | None | $30.20 | $30.20 | $43.65 |
United Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $28.84 | Facility | None | $21.88 | $21.88 | $28.84 |
United Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $40.74 | Professional | None | $18.62 | $29.51 | $40.74 |
Univera Setting Facility Modifier None Typical Low $25.70 Median $29.51 Typical High $29.51 | Facility | None | $25.70 | $29.51 | $29.51 |
Univera Setting Professional Modifier None Typical Low $21.88 Median $26.30 Typical High $35.48 | Professional | None | $21.88 | $26.30 | $35.48 |
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 $10.96 Median $12.02 Typical High $14.45 | Professional | 52 · Reduced service | $10.96 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.79 Typical High $5.75 | Professional | 53 · Discontinued | $4.37 | $4.79 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.63 Typical High $4.27 | Professional | 55 · Aftercare only | $3.31 | $3.63 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.40 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.19 | $2.40 | $2.88 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 50th of 51
$22.91
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.