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 $0.20 Median $0.21 Typical High $0.47 | Facility | None | $0.20 | $0.21 | $0.47 |
Aetna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.24 | Professional | None | $0.20 | $0.20 | $0.24 |
Cigna Setting Facility Modifier None Typical Low $0.22 Median $0.28 Typical High $0.35 | Facility | None | $0.22 | $0.28 | $0.35 |
Cigna Setting Professional Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | None | $0.20 | $0.20 | $0.20 |
Emblem Health Setting Facility Modifier None Typical Low $0.19 Median $0.24 Typical High $0.45 | Facility | None | $0.19 | $0.24 | $0.45 |
Emblem Health Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | None | $0.22 | $0.22 | $0.22 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.16 Median $0.16 Typical High $4.37 | Facility | None | $0.16 | $0.16 | $4.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.16 Median $0.16 Typical High $4.37 | Professional | None | $0.16 | $0.16 | $4.37 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.22 Median $0.22 Typical High $1.07 | Facility | None | $0.22 | $0.22 | $1.07 |
Highmark BCBS Setting Professional Modifier None Typical Low $0.49 Median $1.15 Typical High $1.41 | Professional | None | $0.49 | $1.15 | $1.41 |
MVP Health Care Setting Facility Modifier None Typical Low $0.28 Median $0.28 Typical High $2.00 | Facility | None | $0.28 | $0.28 | $2.00 |
MVP Health Care Setting Professional Modifier None Typical Low $0.28 Median $0.36 Typical High $0.36 | Professional | None | $0.28 | $0.36 | $0.36 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.17 Typical High $4.07 | Professional | None | $0.16 | $0.17 | $4.07 |
Univera Setting Facility Modifier None Typical Low $0.16 Median $0.16 Typical High $4.37 | Facility | None | $0.16 | $0.16 | $4.37 |
Univera Setting Professional Modifier None Typical Low $0.16 Median $0.16 Typical High $4.37 | Professional | None | $0.16 | $0.16 | $4.37 |
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 $0.10 Median $0.10 Typical High $0.10 | Professional | 52 · Reduced service | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 53 · Discontinued | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where New York sits
The same service costs 3.8 times more in Wyoming than in Michigan. 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· 42nd of 51
$0.20
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.