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 $3.24 Median $3.89 Typical High $9.33 | Facility | None | $3.24 | $3.89 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.63 | Professional | None | $3.24 | $3.24 | $3.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
CDPHP Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | None | $2.40 | $2.40 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $2.57 Median $4.27 Typical High $4.90 | Facility | None | $2.57 | $4.27 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $13.49 | Professional | None | $3.24 | $3.24 | $13.49 |
Emblem Health Setting Facility Modifier None Typical Low $3.09 Median $3.72 Typical High $10.96 | Facility | None | $3.09 | $3.72 | $10.96 |
Emblem Health Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $4.27 | Professional | None | $3.24 | $3.24 | $4.27 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.31 | Facility | None | $3.16 | $3.16 | $3.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.31 | Professional | None | $3.16 | $3.16 | $3.31 |
MVP Health Care Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $6.92 | Facility | None | $3.89 | $3.89 | $6.92 |
MVP Health Care Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $2.88 Median $3.39 Typical High $4.27 | Professional | None | $2.88 | $3.39 | $4.27 |
Univera Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.31 | Facility | None | $3.16 | $3.16 | $3.31 |
Univera Setting Professional Modifier None Typical Low $2.69 Median $3.16 Typical High $3.31 | Professional | None | $2.69 | $3.16 | $3.31 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.33 |
Where New York sits
The same service costs 2.0 times more in Arizona than in Oklahoma. 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· 30th of 51
$3.24
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.