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 $6.61 Median $9.77 Typical High $19.05 | Facility | None | $6.61 | $9.77 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $7.59 | Professional | None | $6.61 | $6.61 | $7.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.81 Median $1.00 Typical High $1.15 | Professional | None | $0.81 | $1.00 | $1.15 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Emblem Health Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $13.80 | Facility | None | $8.51 | $8.51 | $13.80 |
Emblem Health Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
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 $9.55 Median $9.77 Typical High $13.49 | Professional | None | $9.55 | $9.77 | $13.49 |
Univera Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Univera Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
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 $3.31 Median $3.31 Typical High $3.80 | Professional | 52 · Reduced service | $3.31 | $3.31 | $3.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.32 Median $1.32 Typical High $1.51 | Professional | 53 · Discontinued | $1.32 | $1.32 | $1.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.98 Median $0.98 Typical High $1.12 | Professional | 55 · Aftercare only | $0.98 | $0.98 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.66 Median $0.66 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.66 | $0.66 | $0.76 |
Where New York sits
The same service costs 13.8 times more in Alaska than in New York. 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· 51st of 51
$1.02
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.