How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.89 Median $1.32 Typical High $2.57 | Facility | None | $0.89 | $1.32 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $1.07 | Professional | None | $0.89 | $0.89 | $1.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.22 Median $0.27 Typical High $0.36 | Professional | None | $0.22 | $0.27 | $0.36 |
Cigna Setting Facility Modifier None Typical Low $0.65 Median $0.69 Typical High $1.12 | Facility | None | $0.65 | $0.69 | $1.12 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
Emblem Health Setting Facility Modifier None Typical Low $1.15 Median $1.15 Typical High $1.86 | Facility | None | $1.15 | $1.15 | $1.86 |
Emblem Health Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.38 | Professional | None | $1.35 | $1.35 | $1.38 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
United Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.49 | Professional | None | $0.36 | $0.36 | $0.49 |
Univera Setting Facility Modifier None Typical Low $0.93 Median $1.10 Typical High $1.10 | Facility | None | $0.93 | $1.10 | $1.10 |
Univera Setting Professional Modifier None Typical Low $0.93 Median $1.10 Typical High $1.10 | Professional | None | $0.93 | $1.10 | $1.10 |
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 $0.45 Median $0.45 Typical High $0.52 | Professional | 52 · Reduced service | $0.45 | $0.45 | $0.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.18 Median $0.18 Typical High $0.21 | Professional | 53 · Discontinued | $0.18 | $0.18 | $0.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.13 Median $0.13 Typical High $0.15 | Professional | 55 · Aftercare only | $0.13 | $0.13 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.10 |
Where New York sits
The same service costs 27.5 times more in Kansas than in New York. 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· 51st of 51
$0.28
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.