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 $2.57 Median $3.39 Typical High $7.59 | Facility | None | $2.57 | $3.39 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
CDPHP Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $2.40 Median $3.47 Typical High $4.07 | Facility | None | $2.40 | $3.47 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $10.96 | Professional | None | $2.69 | $2.69 | $10.96 |
Emblem Health Setting Facility Modifier None Typical Low $2.51 Median $3.24 Typical High $6.03 | Facility | None | $2.51 | $3.24 | $6.03 |
Emblem Health Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.31 | Professional | None | $2.95 | $2.95 | $3.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.69 | Facility | None | $2.57 | $2.57 | $2.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | None | $2.57 | $2.57 | $2.69 |
MVP Health Care Setting Facility Modifier None Typical Low $3.31 Median $3.31 Typical High $5.50 | Facility | None | $3.31 | $3.31 | $5.50 |
MVP Health Care Setting Professional Modifier None Typical Low $2.51 Median $3.16 Typical High $3.55 | Professional | None | $2.51 | $3.16 | $3.55 |
United Setting Professional Modifier None Typical Low $2.57 Median $2.75 Typical High $3.55 | Professional | None | $2.57 | $2.75 | $3.55 |
Univera Setting Facility Modifier None Typical Low $2.57 Median $2.57 Typical High $2.75 | Facility | None | $2.57 | $2.57 | $2.75 |
Univera Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.69 | Professional | None | $2.57 | $2.57 | $2.69 |
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 $1.35 Median $1.35 Typical High $1.35 | Professional | 52 · Reduced service | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 53 · Discontinued | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.27 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 27th of 51
$2.69
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.