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 $0.40 Median $0.40 Typical High $0.93 | Facility | None | $0.40 | $0.40 | $0.93 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Cigna Setting Facility Modifier None Typical Low $0.24 Median $0.52 Typical High $0.60 | Facility | None | $0.24 | $0.52 | $0.60 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Emblem Health Setting Facility Modifier None Typical Low $0.38 Median $0.46 Typical High $1.38 | Facility | None | $0.38 | $0.46 | $1.38 |
Emblem Health Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.59 | Professional | None | $0.40 | $0.40 | $0.59 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.40 Median $0.47 Typical High $0.47 | Facility | None | $0.40 | $0.47 | $0.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.40 Median $0.47 Typical High $0.47 | Professional | None | $0.40 | $0.47 | $0.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.50 Median $0.50 Typical High $0.52 | Facility | None | $0.50 | $0.50 | $0.52 |
MVP Health Care Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $1.02 | Facility | None | $0.65 | $0.65 | $1.02 |
MVP Health Care Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
United Setting Professional Modifier None Typical Low $0.39 Median $0.41 Typical High $0.63 | Professional | None | $0.39 | $0.41 | $0.63 |
Univera Setting Facility Modifier None Typical Low $0.40 Median $0.47 Typical High $0.47 | Facility | None | $0.40 | $0.47 | $0.47 |
Univera Setting Professional Modifier None Typical Low $0.28 Median $0.47 Typical High $0.47 | Professional | None | $0.28 | $0.47 | $0.47 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
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· 29th of 51
$0.40
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.