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 $4.17 Typical High $9.55 | Facility | None | $3.24 | $4.17 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
CDPHP Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $4.37 Typical High $5.25 | Facility | None | $3.09 | $4.37 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $13.80 | Professional | None | $3.47 | $3.47 | $13.80 |
Emblem Health Setting Facility Modifier None Typical Low $3.24 Median $4.17 Typical High $7.76 | Facility | None | $3.24 | $4.17 | $7.76 |
Emblem Health Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $4.90 | Professional | None | $3.72 | $3.72 | $4.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | None | $3.24 | $3.24 | $3.39 |
MVP Health Care Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $7.94 | Facility | None | $4.17 | $4.17 | $7.94 |
MVP Health Care Setting Professional Modifier None Typical Low $3.16 Median $4.07 Typical High $4.47 | Professional | None | $3.16 | $4.07 | $4.47 |
United Setting Facility Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $4.57 | Professional | None | $3.24 | $3.47 | $4.57 |
Univera Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Univera Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | None | $3.24 | $3.24 | $3.39 |
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 $1.74 Median $1.74 Typical High $1.74 | Professional | 52 · Reduced service | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | 53 · Discontinued | $0.69 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $0.35 |
Where New York sits
The same service costs 2.1 times more in Alaska 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· 42nd of 51
$3.47
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.