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 $14.13 Median $21.38 Typical High $41.69 | Facility | None | $14.13 | $21.38 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $25.70 | Professional | None | $14.45 | $14.45 | $25.70 |
CDPHP Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $19.05 Typical High $26.30 | Facility | None | $15.85 | $19.05 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $89.13 | Professional | None | $14.45 | $14.45 | $89.13 |
Emblem Health Setting Facility Modifier None Typical Low $13.80 Median $17.38 Typical High $32.36 | Facility | None | $13.80 | $17.38 | $32.36 |
Emblem Health Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $35.48 | Professional | None | $15.85 | $15.85 | $35.48 |
Excellus BCBS Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.79 | Facility | None | $14.13 | $14.13 | $14.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | None | $14.13 | $14.13 | $14.79 |
MVP Health Care Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $61.66 | Facility | None | $14.45 | $14.45 | $61.66 |
MVP Health Care Setting Professional Modifier None Typical Low $13.49 Median $15.49 Typical High $33.88 | Professional | None | $13.49 | $15.49 | $33.88 |
United Setting Professional Modifier None Typical Low $14.13 Median $15.14 Typical High $33.11 | Professional | None | $14.13 | $15.14 | $33.11 |
Univera Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $15.14 | Facility | None | $14.13 | $14.13 | $15.14 |
Univera Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $16.98 | Professional | None | $12.88 | $14.13 | $16.98 |
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 $7.24 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Where New York sits
The same service costs 2.0 times more in Wyoming 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· 35th of 51
$14.45
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.