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 $0.95 Median $1.41 Typical High $2.75 | Facility | None | $0.95 | $1.41 | $2.75 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $0.95 Typical High $1.17 | Professional | None | $0.95 | $0.95 | $1.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | None | $1.15 | $1.15 | $1.15 |
CDPHP Setting Professional Modifier None Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | None | $1.15 | $1.15 | $1.15 |
Cigna Setting Facility Modifier None Typical Low $1.17 Median $1.23 Typical High $1.78 | Facility | None | $1.17 | $1.23 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $11.22 | Professional | None | $1.17 | $1.17 | $11.22 |
Emblem Health Setting Facility Modifier None Typical Low $1.17 Median $1.17 Typical High $1.91 | Facility | None | $1.17 | $1.17 | $1.91 |
Emblem Health Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.45 | Professional | None | $1.17 | $1.17 | $1.45 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.17 Median $1.23 Typical High $1.23 | Facility | None | $1.17 | $1.23 | $1.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.17 Median $1.23 Typical High $1.23 | Professional | None | $1.17 | $1.23 | $1.23 |
MVP Health Care Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
MVP Health Care Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.23 Typical High $2.29 | Professional | None | $1.15 | $1.23 | $2.29 |
Univera Setting Facility Modifier None Typical Low $1.17 Median $1.23 Typical High $1.45 | Facility | None | $1.17 | $1.23 | $1.45 |
Univera Setting Professional Modifier None Typical Low $1.17 Median $1.23 Typical High $2.29 | Professional | None | $1.17 | $1.23 | $2.29 |
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 $0.48 Median $0.48 Typical High $0.55 | Professional | 52 · Reduced service | $0.48 | $0.48 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.19 Median $0.19 Typical High $0.22 | Professional | 53 · Discontinued | $0.19 | $0.19 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.17 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.11 |
Where New York sits
The same service costs 1.7 times more in Alaska than in Hawaii. 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· 43rd of 51
$1.15
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.