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 $3.09 Median $3.39 Typical High $9.12 | Facility | None | $3.09 | $3.39 | $9.12 |
Aetna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.16 | Professional | None | $3.09 | $3.09 | $3.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $10.72 | Professional | None | $3.09 | $3.09 | $10.72 |
CDPHP Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $4.47 Typical High $11.48 | Facility | None | $3.39 | $4.47 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $6.17 | Professional | None | $3.09 | $3.09 | $6.17 |
Emblem Health Setting Facility Modifier None Typical Low $2.88 Median $3.63 Typical High $6.76 | Facility | None | $2.88 | $3.63 | $6.76 |
Emblem Health Setting Professional Modifier None Typical Low $1.29 Median $3.31 Typical High $3.31 | Professional | None | $1.29 | $3.31 | $3.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.24 | Facility | None | $3.16 | $3.16 | $3.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | None | $3.16 | $3.24 | $3.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.20 Median $0.20 Typical High $0.20 | Facility | None | $0.20 | $0.20 | $0.20 |
MVP Health Care Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $11.22 | Facility | None | $4.17 | $4.17 | $11.22 |
MVP Health Care Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $10.00 | Professional | None | $3.09 | $3.09 | $10.00 |
United Setting Professional Modifier None Typical Low $1.26 Median $3.16 Typical High $4.07 | Professional | None | $1.26 | $3.16 | $4.07 |
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 $3.16 Median $3.24 Typical High $3.24 | Professional | None | $3.16 | $3.24 | $3.24 |
2 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 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.47 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.31 Median $0.31 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.31 | $0.31 | $0.32 |
Where New York sits
The same service costs 3.5 times more in Oklahoma than in Virginia. 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· 26th of 51
$3.16
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.