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 $7.76 Median $8.13 Typical High $23.99 | Facility | None | $7.76 | $8.13 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $8.51 | Professional | None | $7.76 | $7.76 | $8.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $10.00 | Professional | None | $7.76 | $7.76 | $10.00 |
CDPHP Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $6.31 Median $10.23 Typical High $11.75 | Facility | None | $6.31 | $10.23 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $34.67 | Professional | None | $7.76 | $7.76 | $34.67 |
Emblem Health Setting Facility Modifier None Typical Low $7.41 Median $9.33 Typical High $17.38 | Facility | None | $7.41 | $9.33 | $17.38 |
Emblem Health Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $19.95 | Professional | None | $8.51 | $8.51 | $19.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | None | $8.13 | $8.13 | $8.51 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.86 Median $1.86 Typical High $10.72 | Facility | None | $1.86 | $1.86 | $10.72 |
MVP Health Care Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $33.88 | Facility | None | $12.02 | $12.02 | $33.88 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $5.89 Typical High $14.13 | Professional | None | $3.98 | $5.89 | $14.13 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $13.80 | Professional | None | $8.13 | $8.71 | $13.80 |
Univera Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Facility | None | $8.13 | $8.13 | $9.12 |
Univera Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
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 $3.89 Median $3.89 Typical High $3.89 | Professional | 52 · Reduced service | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 53 · Discontinued | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | 55 · Aftercare only | $1.17 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.78 | $0.78 | $0.78 |
Where New York sits
The same service costs 2.6 times more in Texas 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· 32nd 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.