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 $7.76 Median $7.76 Typical High $20.89 | Facility | None | $7.76 | $7.76 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $8.13 | Professional | None | $7.76 | $7.76 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $20.89 | Professional | None | $7.76 | $7.76 | $20.89 |
CDPHP Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | None | $10.72 | $10.72 | $10.72 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $10.72 Typical High $12.30 | Facility | None | $8.51 | $10.72 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $30.20 | Professional | None | $7.76 | $7.76 | $30.20 |
Emblem Health Setting Facility Modifier None Typical Low $7.24 Median $9.12 Typical High $16.98 | Facility | None | $7.24 | $9.12 | $16.98 |
Emblem Health Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $30.90 | Professional | None | $8.32 | $8.32 | $30.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.41 | Facility | None | $7.24 | $7.24 | $7.41 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.41 | Professional | None | $7.24 | $7.24 | $7.41 |
MVP Health Care Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $53.70 | Facility | None | $9.77 | $9.77 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $9.55 Typical High $12.30 | Professional | None | $1.00 | $9.55 | $12.30 |
United Setting Professional Modifier None Typical Low $7.24 Median $7.59 Typical High $21.88 | Professional | None | $7.24 | $7.59 | $21.88 |
Univera Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $7.94 | Facility | None | $7.24 | $7.24 | $7.94 |
Univera Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $8.71 | Professional | None | $7.24 | $7.24 | $8.71 |
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 $3.89 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 53 · Discontinued | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 55 · Aftercare only | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $0.78 |
Where New York sits
The same service costs 3.5 times more in Wyoming than in Maryland. 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· 44th of 51
$7.76
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.