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 $3.24 Median $3.98 Typical High $9.33 | Facility | None | $3.24 | $3.98 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.98 | Professional | None | $3.24 | $3.24 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $4.47 Typical High $10.72 | Professional | None | $4.37 | $4.47 | $10.72 |
CDPHP Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | None | $3.31 | $3.31 | $3.31 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $4.90 Typical High $7.76 | Facility | None | $0.10 | $4.90 | $7.76 |
Emblem Health Setting Professional Modifier None Typical Low $4.57 Median $4.90 Typical High $6.03 | Professional | None | $4.57 | $4.90 | $6.03 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.90 | Facility | None | $4.79 | $4.79 | $4.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.20 Median $4.90 Typical High $4.90 | Professional | None | $1.20 | $4.90 | $4.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Facility | None | $0.89 | $0.89 | $0.89 |
United Setting Professional Modifier None Typical Low $2.34 Median $5.89 Typical High $7.59 | Professional | None | $2.34 | $5.89 | $7.59 |
Univera Setting Facility Modifier None Typical Low $1.20 Median $4.79 Typical High $4.90 | Facility | None | $1.20 | $4.79 | $4.90 |
Univera Setting Professional Modifier None Typical Low $1.20 Median $4.90 Typical High $4.90 | Professional | None | $1.20 | $4.90 | $4.90 |
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 $1.62 Median $1.62 Typical High $2.00 | Professional | 52 · Reduced service | $1.62 | $1.62 | $2.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.79 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.60 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.40 |
Where New York sits
The same service costs 5.9 times more in Hawaii than in Arkansas. 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· 25th of 51
$4.79
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.