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 $5.50 Median $8.13 Typical High $15.85 | Facility | None | $5.50 | $8.13 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Facility | None | $5.50 | $5.50 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
CDPHP Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $6.03 Median $7.24 Typical High $8.13 | Facility | None | $6.03 | $7.24 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $23.44 | Professional | None | $5.50 | $5.50 | $23.44 |
Emblem Health Setting Facility Modifier None Typical Low $5.13 Median $6.17 Typical High $18.62 | Facility | None | $5.13 | $6.17 | $18.62 |
Emblem Health Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | None | $5.50 | $5.50 | $7.76 |
Excellus BCBS Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Facility | None | $5.50 | $5.50 | $5.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | None | $5.50 | $5.50 | $5.62 |
MVP Health Care Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $11.75 | Facility | None | $6.92 | $6.92 | $11.75 |
MVP Health Care Setting Professional Modifier None Typical Low $5.37 Median $6.76 Typical High $7.59 | Professional | None | $5.37 | $6.76 | $7.59 |
United Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
United Setting Professional Modifier None Typical Low $5.50 Median $6.17 Typical High $7.76 | Professional | None | $5.50 | $6.17 | $7.76 |
Univera Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Facility | None | $5.50 | $5.50 | $5.75 |
Univera Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | None | $5.50 | $5.50 | $5.62 |
5 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 $2.75 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.55 | $0.55 | $0.55 |
Highmark BCBS Setting Facility Modifier JW · Drug discarded Typical Low $5.37 Median $5.37 Typical High $5.50 | Facility | JW · Drug discarded | $5.37 | $5.37 | $5.50 |
Where New York sits
The same service costs 1.9 times more in Alaska than in New Mexico. 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· 40th of 51
$5.50
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.