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 $4.27 Median $5.50 Typical High $12.30 | Facility | None | $4.27 | $5.50 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.37 | Facility | None | $4.27 | $4.27 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.16 Median $4.37 Typical High $4.37 | Professional | None | $3.16 | $4.37 | $4.37 |
CDPHP Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $5.75 Typical High $6.61 | Facility | None | $3.55 | $5.75 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $18.20 | Professional | None | $4.37 | $4.37 | $18.20 |
Emblem Health Setting Facility Modifier None Typical Low $4.17 Median $5.25 Typical High $9.77 | Facility | None | $4.17 | $5.25 | $9.77 |
Emblem Health Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $7.41 | Professional | None | $4.79 | $4.79 | $7.41 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.37 | Facility | None | $4.27 | $4.27 | $4.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.37 | Professional | None | $4.27 | $4.27 | $4.37 |
Highmark BCBS Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Facility | None | $6.92 | $6.92 | $6.92 |
MVP Health Care Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $14.13 | Facility | None | $5.37 | $5.37 | $14.13 |
MVP Health Care Setting Professional Modifier None Typical Low $2.75 Median $5.01 Typical High $5.01 | Professional | None | $2.75 | $5.01 | $5.01 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.47 Typical High $6.46 | Professional | None | $4.27 | $4.47 | $6.46 |
Univera Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Facility | None | $4.27 | $4.27 | $4.47 |
Univera Setting Professional Modifier None Typical Low $0.79 Median $4.27 Typical High $4.37 | Professional | None | $0.79 | $4.27 | $4.37 |
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 $2.19 Median $2.19 Typical High $2.19 | Professional | 52 · Reduced service | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 53 · Discontinued | $0.87 | $0.87 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | 55 · Aftercare only | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.44 | $0.44 | $0.44 |
Where New York sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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· 38th of 51
$4.37
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.