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 $0.54 Median $0.54 Typical High $1.12 | Facility | None | $0.54 | $0.54 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.91 | Professional | None | $0.54 | $0.54 | $0.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $1.82 | Professional | None | $0.54 | $0.54 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $0.59 Median $0.76 Typical High $0.93 | Facility | None | $0.59 | $0.76 | $0.93 |
Cigna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | None | $0.54 | $0.54 | $0.54 |
Emblem Health Setting Facility Modifier None Typical Low $0.51 Median $0.65 Typical High $1.20 | Facility | None | $0.51 | $0.65 | $1.20 |
Emblem Health Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $2.45 | Professional | None | $0.58 | $0.58 | $2.45 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.54 Median $0.54 Typical High $0.56 | Facility | None | $0.54 | $0.54 | $0.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.56 | Professional | None | $0.54 | $0.54 | $0.56 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.65 Median $1.12 Typical High $2.95 | Facility | None | $0.65 | $1.12 | $2.95 |
MVP Health Care Setting Facility Modifier None Typical Low $0.63 Median $0.72 Typical High $3.47 | Facility | None | $0.63 | $0.72 | $3.47 |
MVP Health Care Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $1.26 | Professional | None | $0.72 | $0.72 | $1.26 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.56 Typical High $2.14 | Professional | None | $0.54 | $0.56 | $2.14 |
Univera Setting Facility Modifier None Typical Low $0.54 Median $0.54 Typical High $0.65 | Facility | None | $0.54 | $0.54 | $0.65 |
Univera Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $5.50 | Professional | None | $0.54 | $0.54 | $5.50 |
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 $0.27 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where New York sits
The same service costs 6.3 times more in Texas than in Mississippi. 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· 41st of 51
$0.54
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.