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 $8.13 Median $8.13 Typical High $12.02 | Facility | None | $8.13 | $8.13 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | None | $8.13 | $8.13 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $8.13 Typical High $8.13 | Professional | None | $5.01 | $8.13 | $8.13 |
CDPHP Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $10.72 Typical High $12.02 | Facility | None | $3.16 | $10.72 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $19.05 | Professional | None | $8.13 | $8.13 | $19.05 |
Emblem Health Setting Facility Modifier None Typical Low $7.59 Median $9.55 Typical High $17.78 | Facility | None | $7.59 | $9.55 | $17.78 |
Emblem Health Setting Professional Modifier None Typical Low $3.24 Median $8.71 Typical High $8.71 | Professional | None | $3.24 | $8.71 | $8.71 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.45 Median $4.47 Typical High $4.47 | Facility | None | $2.45 | $4.47 | $4.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.45 Median $4.47 Typical High $4.47 | Professional | None | $2.45 | $4.47 | $4.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.35 Median $4.47 Typical High $15.49 | Facility | None | $1.35 | $4.47 | $15.49 |
MVP Health Care Setting Facility Modifier None Typical Low $5.01 Median $5.75 Typical High $9.55 | Facility | None | $5.01 | $5.75 | $9.55 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $1.20 Typical High $6.17 | Professional | None | $1.00 | $1.20 | $6.17 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $6.76 | Professional | None | $4.47 | $4.68 | $6.76 |
Univera Setting Facility Modifier None Typical Low $2.45 Median $4.47 Typical High $4.68 | Facility | None | $2.45 | $4.47 | $4.68 |
Univera Setting Professional Modifier None Typical Low $2.24 Median $4.47 Typical High $4.47 | Professional | None | $2.24 | $4.47 | $4.47 |
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 $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Where New York sits
The same service costs 10.7 times more in Minnesota 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· 31st of 51
$8.13
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.