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 $4.47 Median $4.47 Typical High $10.00 | Facility | None | $4.47 | $4.47 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $5.01 | Professional | None | $4.47 | $4.47 | $5.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | None | $4.47 | $4.47 | $4.47 |
CDPHP Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $6.61 Typical High $7.76 | Facility | None | $4.90 | $6.61 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $37.15 | Professional | None | $4.47 | $4.47 | $37.15 |
Emblem Health Setting Facility Modifier None Typical Low $4.27 Median $5.37 Typical High $10.00 | Facility | None | $4.27 | $5.37 | $10.00 |
Emblem Health Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $12.02 | Professional | None | $4.90 | $4.90 | $12.02 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.37 | Facility | None | $4.17 | $4.17 | $4.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $4.37 | Professional | None | $4.17 | $4.17 | $4.37 |
Highmark BCBS Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $8.32 | Facility | None | $7.94 | $7.94 | $8.32 |
MVP Health Care Setting Facility Modifier None Typical Low $6.17 Median $6.17 Typical High $21.88 | Facility | None | $6.17 | $6.17 | $21.88 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $6.61 Typical High $9.12 | Professional | None | $3.98 | $6.61 | $9.12 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $12.30 | Professional | None | $4.17 | $4.47 | $12.30 |
Univera Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $5.01 | Facility | None | $4.17 | $4.17 | $5.01 |
Univera Setting Professional Modifier None Typical Low $4.17 Median $4.17 Typical High $30.20 | Professional | None | $4.17 | $4.17 | $30.20 |
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 $2.24 Median $2.24 Typical High $2.24 | Professional | 52 · Reduced service | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | 53 · Discontinued | $0.89 | $0.89 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.68 Median $0.68 Typical High $0.68 | Professional | 55 · Aftercare only | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.45 | $0.45 | $0.45 |
Where New York sits
The same service costs 5.9 times more in Texas than in Rhode Island. 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· 34th of 51
$4.47
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.