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 $1.29 Median $1.66 Typical High $3.72 | Facility | None | $1.29 | $1.66 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.32 | Facility | None | $1.29 | $1.29 | $1.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
CDPHP Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Cigna Setting Facility Modifier None Typical Low $1.07 Median $1.74 Typical High $2.14 | Facility | None | $1.07 | $1.74 | $2.14 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $5.50 | Professional | None | $1.41 | $1.41 | $5.50 |
Emblem Health Setting Facility Modifier None Typical Low $1.29 Median $1.66 Typical High $3.09 | Facility | None | $1.29 | $1.66 | $3.09 |
Emblem Health Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.86 | Professional | None | $1.51 | $1.51 | $1.86 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Facility | None | $1.29 | $1.29 | $1.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | None | $1.29 | $1.29 | $1.35 |
MVP Health Care Setting Facility Modifier None Typical Low $1.66 Median $1.66 Typical High $2.57 | Facility | None | $1.66 | $1.66 | $2.57 |
MVP Health Care Setting Professional Modifier None Typical Low $1.20 Median $1.55 Typical High $1.62 | Professional | None | $1.20 | $1.55 | $1.62 |
United Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.38 Typical High $1.78 | Professional | None | $1.29 | $1.38 | $1.78 |
Univera Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Facility | None | $1.29 | $1.29 | $1.35 |
Univera Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.35 | Professional | None | $1.29 | $1.29 | $1.35 |
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 $0.69 Median $0.69 Typical High $0.69 | Professional | 52 · Reduced service | $0.69 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Iowa. 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· 31st of 51
$1.38
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.