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 $3.89 Median $4.27 Typical High $30.20 | Facility | None | $3.89 | $4.27 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $4.37 | Professional | None | $3.89 | $3.89 | $4.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $7.76 | Professional | None | $3.89 | $3.89 | $7.76 |
CDPHP Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $4.27 Median $5.37 Typical High $6.92 | Facility | None | $4.27 | $5.37 | $6.92 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $43.65 | Professional | None | $3.89 | $3.89 | $43.65 |
Emblem Health Setting Facility Modifier None Typical Low $3.72 Median $4.68 Typical High $8.71 | Facility | None | $3.72 | $4.68 | $8.71 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $7.41 | Professional | None | $4.27 | $4.27 | $7.41 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.72 | Facility | None | $10.47 | $10.47 | $10.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.72 | Professional | None | $10.47 | $10.47 | $10.72 |
MVP Health Care Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $12.88 | Facility | None | $5.13 | $5.13 | $12.88 |
MVP Health Care Setting Professional Modifier None Typical Low $2.00 Median $6.03 Typical High $19.95 | Professional | None | $2.00 | $6.03 | $19.95 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.96 Typical High $14.79 | Professional | None | $10.47 | $10.96 | $14.79 |
Univera Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.96 | Facility | None | $10.47 | $10.47 | $10.96 |
Univera Setting Professional Modifier None Typical Low $1.78 Median $10.47 Typical High $10.72 | Professional | None | $1.78 | $10.47 | $10.72 |
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 $1.95 Median $1.95 Typical High $1.95 | Professional | 52 · Reduced service | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 53 · Discontinued | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.39 |
Where New York sits
The same service costs 3.2 times more in Hawaii than in Georgia. 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· 30th of 51
$5.37
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.