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 $0.89 Median $1.10 Typical High $2.95 | Facility | None | $0.89 | $1.10 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $2.63 | Professional | None | $0.89 | $0.89 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $1.00 Median $1.20 Typical High $1.35 | Facility | None | $1.00 | $1.20 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $6.31 | Professional | None | $0.89 | $0.89 | $6.31 |
Emblem Health Setting Facility Modifier None Typical Low $0.85 Median $1.07 Typical High $2.00 | Facility | None | $0.85 | $1.07 | $2.00 |
Emblem Health Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $3.09 | Professional | None | $0.98 | $0.98 | $3.09 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $1.07 | Facility | None | $1.02 | $1.02 | $1.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.07 | Professional | None | $1.02 | $1.02 | $1.07 |
MVP Health Care Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $4.37 | Facility | None | $0.85 | $0.85 | $4.37 |
MVP Health Care Setting Professional Modifier None Typical Low $0.89 Median $0.98 Typical High $2.29 | Professional | None | $0.89 | $0.98 | $2.29 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.07 Typical High $2.88 | Professional | None | $1.02 | $1.07 | $2.88 |
Univera Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $1.23 | Facility | None | $1.02 | $1.02 | $1.23 |
Univera Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $2.14 | Professional | None | $1.02 | $1.02 | $2.14 |
2 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 55 · Aftercare only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 55 · Aftercare only | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.09 | $0.09 | $0.09 |
Where New York sits
The same service costs 2.3 times more in South Carolina than in North Dakota. 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· 20th of 51
$1.02
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.