How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.63 Median $0.95 Typical High $1.82 | Facility | None | $0.63 | $0.95 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $0.74 | Professional | None | $0.63 | $0.63 | $0.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.56 Median $0.69 Typical High $0.79 | Professional | None | $0.56 | $0.69 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $0.79 Median $0.85 Typical High $1.20 | Facility | None | $0.79 | $0.85 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $2.29 | Professional | None | $0.79 | $0.79 | $2.29 |
Emblem Health Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $1.26 | Facility | None | $0.78 | $0.78 | $1.26 |
Emblem Health Setting Professional Modifier None Typical Low $0.91 Median $5.01 Typical High $5.01 | Professional | None | $0.91 | $5.01 | $5.01 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.85 Typical High $1.12 | Professional | None | $0.79 | $0.85 | $1.12 |
Univera Setting Facility Modifier None Typical Low $0.63 Median $0.74 Typical High $0.74 | Facility | None | $0.63 | $0.74 | $0.74 |
Univera Setting Professional Modifier None Typical Low $0.63 Median $0.74 Typical High $0.74 | Professional | None | $0.63 | $0.74 | $0.74 |
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 $0.32 Median $0.32 Typical High $0.37 | Professional | 52 · Reduced service | $0.32 | $0.32 | $0.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.15 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.11 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.07 |
Where New York sits
The same service costs 13.8 times more in Kansas than in Montana. 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· 50th of 51
$0.72
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.