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 $7.08 Median $7.94 Typical High $19.95 | Facility | None | $7.08 | $7.94 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Facility | None | $6.92 | $6.92 | $7.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $10.00 Typical High $11.22 | Facility | None | $8.32 | $10.00 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $29.51 | Professional | None | $7.59 | $7.59 | $29.51 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $8.32 Typical High $15.85 | Facility | None | $7.08 | $8.32 | $15.85 |
Emblem Health Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $8.91 | Professional | None | $7.59 | $7.59 | $8.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Facility | None | $6.92 | $6.92 | $7.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | None | $6.92 | $6.92 | $7.08 |
Highmark BCBS Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
MVP Health Care Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $14.13 | Facility | None | $8.71 | $8.71 | $14.13 |
MVP Health Care Setting Professional Modifier None Typical Low $6.31 Median $8.13 Typical High $8.71 | Professional | None | $6.31 | $8.13 | $8.71 |
United Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
United Setting Professional Modifier None Typical Low $6.92 Median $7.24 Typical High $9.55 | Professional | None | $6.92 | $7.24 | $9.55 |
Univera Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $7.24 | Facility | None | $6.92 | $6.92 | $7.24 |
Univera Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $7.08 | Professional | None | $6.92 | $6.92 | $7.08 |
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 $3.80 Median $3.80 Typical High $3.80 | Professional | 52 · Reduced service | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 53 · Discontinued | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $0.76 |
Where New York sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 39th of 51
$7.59
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.