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 $5.13 Median $6.61 Typical High $14.79 | Facility | None | $5.13 | $6.61 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.25 | Facility | None | $5.13 | $5.13 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $8.51 | Professional | None | $5.13 | $5.13 | $8.51 |
CDPHP Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
Cigna Setting Facility Modifier None Typical Low $4.79 Median $6.76 Typical High $7.76 | Facility | None | $4.79 | $6.76 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $21.88 | Professional | None | $5.13 | $5.13 | $21.88 |
Emblem Health Setting Facility Modifier None Typical Low $4.79 Median $6.17 Typical High $11.48 | Facility | None | $4.79 | $6.17 | $11.48 |
Emblem Health Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $7.76 | Professional | None | $5.62 | $5.62 | $7.76 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Facility | None | $5.13 | $5.13 | $5.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Professional | None | $5.13 | $5.13 | $5.37 |
MVP Health Care Setting Facility Modifier None Typical Low $0.56 Median $0.68 Typical High $13.18 | Facility | None | $0.56 | $0.68 | $13.18 |
MVP Health Care Setting Professional Modifier None Typical Low $5.37 Median $6.31 Typical High $6.31 | Professional | None | $5.37 | $6.31 | $6.31 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $5.13 Median $5.50 Typical High $7.59 | Professional | None | $5.13 | $5.50 | $7.59 |
Univera Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Facility | None | $5.13 | $5.13 | $5.37 |
Univera Setting Professional Modifier None Typical Low $4.17 Median $5.13 Typical High $5.37 | Professional | None | $4.17 | $5.13 | $5.37 |
5 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 $2.57 Median $2.57 Typical High $2.57 | Professional | 52 · Reduced service | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.51 |
Highmark BCBS Setting Facility Modifier JZ · No drug discarded Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | JZ · No drug discarded | $6.31 | $6.31 | $6.31 |
Where New York sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 36th of 51
$5.13
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.