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 $3.55 Median $3.55 Typical High $7.94 | Facility | None | $3.55 | $3.55 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $11.75 | Professional | None | $3.55 | $3.55 | $11.75 |
CDPHP Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $5.13 Typical High $10.72 | Facility | None | $3.89 | $5.13 | $10.72 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $14.79 | Professional | None | $3.55 | $3.55 | $14.79 |
Emblem Health Setting Facility Modifier None Typical Low $3.39 Median $8.91 Typical High $14.13 | Facility | None | $3.39 | $8.91 | $14.13 |
Emblem Health Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $10.96 | Professional | None | $3.89 | $3.89 | $10.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.55 | Facility | None | $3.39 | $3.39 | $3.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.55 | Professional | None | $3.39 | $3.39 | $3.55 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.86 Median $9.77 Typical High $10.23 | Facility | None | $1.86 | $9.77 | $10.23 |
MVP Health Care Setting Facility Modifier None Typical Low $3.89 Median $4.57 Typical High $20.89 | Facility | None | $3.89 | $4.57 | $20.89 |
MVP Health Care Setting Professional Modifier None Typical Low $6.03 Median $6.92 Typical High $16.98 | Professional | None | $6.03 | $6.92 | $16.98 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.63 Typical High $11.48 | Professional | None | $3.39 | $3.63 | $11.48 |
Univera Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $4.07 | Facility | None | $3.39 | $3.39 | $4.07 |
Univera Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $5.75 | Professional | None | $3.39 | $3.39 | $5.75 |
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 $1.78 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where New York sits
The same service costs 4.0 times more in Oklahoma than in Maryland. 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· 46th of 51
$3.55
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.