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 $22.91 Median $22.91 Typical High $45.71 | Facility | None | $22.91 | $22.91 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | None | $22.91 | $22.91 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.18 Median $22.91 Typical High $22.91 | Professional | None | $13.18 | $22.91 | $22.91 |
CDPHP Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $15.14 Median $30.20 Typical High $41.69 | Facility | None | $15.14 | $30.20 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $93.33 | Professional | None | $22.91 | $22.91 | $93.33 |
Emblem Health Setting Facility Modifier None Typical Low $16.60 Median $21.88 Typical High $48.98 | Facility | None | $16.60 | $21.88 | $48.98 |
Emblem Health Setting Professional Modifier None Typical Low $21.88 Median $25.12 Typical High $25.12 | Professional | None | $21.88 | $25.12 | $25.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $22.91 | Facility | None | $22.39 | $22.39 | $22.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.91 | Professional | None | $22.39 | $22.39 | $22.91 |
Highmark BCBS Setting Facility Modifier None Typical Low $4.17 Median $19.50 Typical High $32.36 | Facility | None | $4.17 | $19.50 | $32.36 |
MVP Health Care Setting Facility Modifier None Typical Low $23.44 Median $26.92 Typical High $34.67 | Facility | None | $23.44 | $26.92 | $34.67 |
MVP Health Care Setting Professional Modifier None Typical Low $5.01 Median $8.91 Typical High $24.55 | Professional | None | $5.01 | $8.91 | $24.55 |
United Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $31.62 | Professional | None | $19.95 | $23.44 | $31.62 |
Univera Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $23.44 | Facility | None | $22.39 | $22.39 | $23.44 |
Univera Setting Professional Modifier None Typical Low $4.37 Median $22.39 Typical High $22.91 | Professional | None | $4.37 | $22.39 | $22.91 |
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 $11.48 Median $11.48 Typical High $11.48 | Professional | 52 · Reduced service | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | 55 · Aftercare only | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.29 |
Where New York sits
The same service costs 2.0 times more in Minnesota than in Hawaii. 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· 38th of 51
$22.91
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.