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 $0.59 Median $0.66 Typical High $1.82 | Facility | None | $0.59 | $0.66 | $1.82 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $2.69 | Professional | None | $0.60 | $0.60 | $2.69 |
Cigna Setting Facility Modifier None Typical Low $0.65 Median $0.85 Typical High $1.10 | Facility | None | $0.65 | $0.85 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $6.03 | Professional | None | $0.60 | $0.60 | $6.03 |
Emblem Health Setting Facility Modifier None Typical Low $0.56 Median $0.72 Typical High $1.32 | Facility | None | $0.56 | $0.72 | $1.32 |
Emblem Health Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $2.51 | Professional | None | $0.65 | $0.65 | $2.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $0.65 | Facility | None | $0.62 | $0.62 | $0.65 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.65 | Professional | None | $0.62 | $0.62 | $0.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
MVP Health Care Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $4.37 | Facility | None | $0.78 | $0.78 | $4.37 |
MVP Health Care Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.45 | Professional | None | $1.10 | $1.10 | $1.45 |
United Setting Professional Modifier None Typical Low $0.62 Median $0.83 Typical High $3.55 | Professional | None | $0.62 | $0.83 | $3.55 |
Univera Setting Facility Modifier None Typical Low $0.62 Median $0.62 Typical High $0.74 | Facility | None | $0.62 | $0.62 | $0.74 |
Univera Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $1.55 | Professional | None | $0.62 | $0.62 | $1.55 |
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 $0.30 Median $0.30 Typical High $0.30 | Professional | 52 · Reduced service | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where New York sits
The same service costs 3.4 times more in Wyoming than in Delaware. 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· 45th of 51
$0.62
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.