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 $8.51 Median $8.51 Typical High $21.88 | Facility | None | $8.51 | $8.51 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $61.66 | Professional | None | $8.51 | $8.51 | $61.66 |
CDPHP Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $12.30 Typical High $36.31 | Facility | None | $9.33 | $12.30 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $39.81 | Professional | None | $8.51 | $8.51 | $39.81 |
Emblem Health Setting Facility Modifier None Typical Low $7.94 Median $10.23 Typical High $19.05 | Facility | None | $7.94 | $10.23 | $19.05 |
Emblem Health Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $50.12 | Professional | None | $9.33 | $9.33 | $50.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.77 | Facility | None | $9.33 | $9.33 | $9.77 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | None | $9.33 | $9.33 | $9.77 |
MVP Health Care Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $77.62 | Facility | None | $14.79 | $14.79 | $77.62 |
MVP Health Care Setting Professional Modifier None Typical Low $2.00 Median $19.95 Typical High $69.18 | Professional | None | $2.00 | $19.95 | $69.18 |
United Setting Professional Modifier None Typical Low $9.33 Median $10.00 Typical High $51.29 | Professional | None | $9.33 | $10.00 | $51.29 |
Univera Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $11.22 | Facility | None | $9.33 | $9.33 | $11.22 |
Univera Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $30.20 | Professional | None | $9.33 | $9.33 | $30.20 |
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 $4.27 Median $4.27 Typical High $4.27 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.85 |
Where New York sits
The same service costs 6.5 times more in Oklahoma than in Alabama. 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· 30th of 51
$9.33
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.