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 $8.71 Median $12.88 Typical High $25.12 | Facility | None | $8.71 | $12.88 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | None | $8.71 | $8.71 | $10.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $25.70 | Professional | None | $10.47 | $10.47 | $25.70 |
CDPHP Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.72 Typical High $85.11 | Facility | None | $10.00 | $10.72 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $56.23 | Professional | None | $10.72 | $10.72 | $56.23 |
Emblem Health Setting Facility Modifier None Typical Low $9.77 Median $11.75 Typical High $21.88 | Facility | None | $9.77 | $11.75 | $21.88 |
Emblem Health Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $13.49 | Professional | None | $10.72 | $10.72 | $13.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.72 Median $11.22 Typical High $11.22 | Facility | None | $10.72 | $11.22 | $11.22 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | None | $10.72 | $11.22 | $11.22 |
MVP Health Care Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $22.91 | Facility | None | $13.18 | $13.18 | $22.91 |
MVP Health Care Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $16.60 | Professional | None | $12.02 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $10.47 Median $11.22 Typical High $15.85 | Professional | None | $10.47 | $11.22 | $15.85 |
Univera Setting Facility Modifier None Typical Low $10.72 Median $11.22 Typical High $11.22 | Facility | None | $10.72 | $11.22 | $11.22 |
Univera Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $11.75 | Professional | None | $10.72 | $11.22 | $11.75 |
2 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 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.51 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $1.00 |
Where New York sits
The same service costs 11.5 times more in Alabama than in South Dakota. 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· 47th of 51
$10.47
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.