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 $12.02 Median $12.88 Typical High $35.48 | Facility | None | $12.02 | $12.88 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $20.89 | Professional | None | $12.02 | $12.02 | $20.89 |
CDPHP Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $17.38 Typical High $61.66 | Facility | None | $13.18 | $17.38 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Emblem Health Setting Facility Modifier None Typical Low $11.22 Median $22.39 Typical High $40.74 | Facility | None | $11.22 | $22.39 | $40.74 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $26.30 | Professional | None | $22.39 | $22.39 | $26.30 |
Excellus BCBS Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $13.18 | Facility | None | $12.30 | $12.30 | $13.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $13.18 | Professional | None | $12.30 | $12.30 | $13.18 |
MVP Health Care Setting Facility Modifier None Typical Low $12.30 Median $14.13 Typical High $45.71 | Facility | None | $12.30 | $14.13 | $45.71 |
MVP Health Care Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $15.85 | Professional | None | $12.59 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $12.30 Median $16.60 Typical High $30.20 | Professional | None | $12.30 | $16.60 | $30.20 |
Univera Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $14.79 | Facility | None | $12.30 | $12.30 | $14.79 |
Univera Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $67.61 | Professional | None | $12.30 | $12.30 | $67.61 |
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 $6.03 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Where New York sits
The same service costs 1.9 times more in Alaska than in Pennsylvania. 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· 38th of 51
$12.30
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.