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 $1.29 Median $1.29 Typical High $2.63 | Facility | None | $1.29 | $1.29 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.45 | Professional | None | $1.29 | $1.29 | $1.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $4.90 | Professional | None | $1.29 | $1.29 | $4.90 |
CDPHP Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | None | $1.78 | $1.78 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.86 Typical High $2.04 | Facility | None | $1.41 | $1.86 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Emblem Health Setting Facility Modifier None Typical Low $1.23 Median $1.55 Typical High $2.88 | Facility | None | $1.23 | $1.55 | $2.88 |
Emblem Health Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $3.98 | Professional | None | $1.41 | $1.41 | $3.98 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.32 | Facility | None | $1.26 | $1.26 | $1.32 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $1.32 | Professional | None | $1.26 | $1.26 | $1.32 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.38 Median $2.75 Typical High $4.90 | Facility | None | $1.38 | $2.75 | $4.90 |
MVP Health Care Setting Facility Modifier None Typical Low $1.58 Median $1.58 Typical High $6.31 | Facility | None | $1.58 | $1.58 | $6.31 |
MVP Health Care Setting Professional Modifier None Typical Low $1.35 Median $1.55 Typical High $3.02 | Professional | None | $1.35 | $1.55 | $3.02 |
United Setting Professional Modifier None Typical Low $1.26 Median $1.35 Typical High $4.68 | Professional | None | $1.26 | $1.35 | $4.68 |
Univera Setting Facility Modifier None Typical Low $1.26 Median $1.26 Typical High $1.51 | Facility | None | $1.26 | $1.26 | $1.51 |
Univera Setting Professional Modifier None Typical Low $1.26 Median $1.26 Typical High $3.09 | Professional | None | $1.26 | $1.26 | $3.09 |
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 $0.65 Median $0.65 Typical High $0.65 | Professional | 52 · Reduced service | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 53 · Discontinued | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where New York sits
The same service costs 2.5 times more in Texas than in Nebraska. 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· 40th of 51
$1.29
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.