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 $2.19 Median $2.69 Typical High $6.46 | Facility | None | $2.19 | $2.69 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.57 | Professional | None | $2.19 | $2.19 | $2.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.63 Median $2.63 Typical High $2.75 | Facility | None | $2.63 | $2.63 | $2.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $2.63 | Professional | None | $2.63 | $2.63 | $2.63 |
CDPHP Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $4.79 | Facility | None | $2.09 | $2.09 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $14.45 | Professional | None | $2.69 | $2.69 | $14.45 |
Emblem Health Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $4.47 | Facility | None | $2.75 | $2.75 | $4.47 |
Emblem Health Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $3.47 | Professional | None | $2.75 | $2.75 | $3.47 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Professional | None | $2.69 | $2.82 | $2.82 |
MVP Health Care Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
United Setting Facility Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Facility | None | $2.75 | $2.75 | $2.75 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.82 Typical High $3.63 | Professional | None | $2.40 | $2.82 | $3.63 |
Univera Setting Facility Modifier None Typical Low $2.69 Median $2.82 Typical High $2.82 | Facility | None | $2.69 | $2.82 | $2.82 |
Univera Setting Professional Modifier None Typical Low $0.60 Median $2.82 Typical High $2.82 | Professional | None | $0.60 | $2.82 | $2.82 |
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 $1.12 Median $1.12 Typical High $1.29 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | 53 · Discontinued | $0.44 | $0.44 | $0.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.33 Typical High $0.38 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.26 |
Where New York sits
The same service costs 1.8 times more in Arizona 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· 46th of 51
$2.63
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.