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 $4.90 Median $7.24 Typical High $14.13 | Facility | None | $4.90 | $7.24 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.62 | Professional | None | $4.90 | $4.90 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $6.31 Typical High $15.85 | Professional | None | $0.02 | $6.31 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $6.61 Typical High $10.72 | Facility | None | $6.17 | $6.61 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $34.67 | Professional | None | $6.17 | $6.17 | $34.67 |
Emblem Health Setting Facility Modifier None Typical Low $6.31 Median $6.92 Typical High $12.88 | Facility | None | $6.31 | $6.92 | $12.88 |
Emblem Health Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | None | $6.31 | $6.31 | $7.41 |
MVP Health Care Setting Professional Modifier None Typical Low $7.24 Median $8.32 Typical High $8.32 | Professional | None | $7.24 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $12.30 Median $13.18 Typical High $16.98 | Professional | None | $12.30 | $13.18 | $16.98 |
Univera Setting Facility Modifier None Typical Low $4.79 Median $4.90 Typical High $4.90 | Facility | None | $4.79 | $4.90 | $4.90 |
Univera Setting Professional Modifier None Typical Low $4.79 Median $4.90 Typical High $4.90 | Professional | None | $4.79 | $4.90 | $4.90 |
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 $2.45 Median $2.45 Typical High $2.82 | Professional | 52 · Reduced service | $2.45 | $2.45 | $2.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.98 Median $0.98 Typical High $1.12 | Professional | 53 · Discontinued | $0.98 | $0.98 | $1.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.83 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $0.49 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.49 | $0.49 | $0.56 |
Where New York sits
The same service costs 2.1 times more in Iowa 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· 6th of 51
$10.72
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.