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 $4.27 Median $6.03 Typical High $13.80 | Facility | None | $4.27 | $6.03 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $15.85 | Professional | None | $4.27 | $4.27 | $15.85 |
CDPHP Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $6.17 Typical High $12.30 | Facility | None | $4.68 | $6.17 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $19.95 | Professional | None | $4.27 | $4.27 | $19.95 |
Emblem Health Setting Facility Modifier None Typical Low $3.98 Median $10.72 Typical High $16.98 | Facility | None | $3.98 | $10.72 | $16.98 |
Emblem Health Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $12.30 | Professional | None | $4.57 | $4.57 | $12.30 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $4.90 | Facility | None | $4.68 | $4.68 | $4.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $4.90 | Professional | None | $4.68 | $4.68 | $4.90 |
MVP Health Care Setting Facility Modifier None Typical Low $7.24 Median $7.24 Typical High $20.89 | Facility | None | $7.24 | $7.24 | $20.89 |
MVP Health Care Setting Professional Modifier None Typical Low $2.00 Median $10.96 Typical High $13.49 | Professional | None | $2.00 | $10.96 | $13.49 |
United Setting Professional Modifier None Typical Low $4.68 Median $5.01 Typical High $13.18 | Professional | None | $4.68 | $5.01 | $13.18 |
Univera Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $5.62 | Facility | None | $4.68 | $4.68 | $5.62 |
Univera Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.76 | Professional | None | $4.68 | $4.68 | $6.76 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.63 Typical High $0.63 | Professional | 55 · Aftercare only | $0.63 | $0.63 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.42 | $0.42 | $0.42 |
Where New York sits
The same service costs 3.4 times more in Texas than in Georgia. 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· 40th of 51
$4.68
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.