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 $0.76 Median $1.12 Typical High $2.45 | Facility | None | $0.76 | $1.12 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $4.07 | Professional | None | $0.76 | $0.76 | $4.07 |
CDPHP Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Cigna Setting Facility Modifier None Typical Low $0.83 Median $1.12 Typical High $1.35 | Facility | None | $0.83 | $1.12 | $1.35 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
Emblem Health Setting Facility Modifier None Typical Low $0.72 Median $0.91 Typical High $1.70 | Facility | None | $0.72 | $0.91 | $1.70 |
Emblem Health Setting Professional Modifier None Typical Low $0.83 Median $0.83 Typical High $3.72 | Professional | None | $0.83 | $0.83 | $3.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.89 | Facility | None | $0.85 | $0.85 | $0.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $0.89 | Professional | None | $0.85 | $0.85 | $0.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $6.46 | Facility | None | $1.05 | $1.05 | $6.46 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $1.10 Typical High $2.24 | Professional | None | $1.00 | $1.10 | $2.24 |
United Setting Professional Modifier None Typical Low $0.85 Median $0.89 Typical High $2.69 | Professional | None | $0.85 | $0.89 | $2.69 |
Univera Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $1.02 | Facility | None | $0.85 | $0.85 | $1.02 |
Univera Setting Professional Modifier None Typical Low $0.85 Median $0.85 Typical High $2.40 | Professional | None | $0.85 | $0.85 | $2.40 |
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 $0.38 Median $0.38 Typical High $0.38 | Professional | 52 · Reduced service | $0.38 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where New York sits
The same service costs 3.9 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· 17th of 51
$0.85
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.