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 $2.19 Median $2.19 Typical High $5.75 | Facility | None | $2.19 | $2.19 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $3.24 | Professional | None | $2.19 | $2.19 | $3.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $5.50 | Professional | None | $2.19 | $2.19 | $5.50 |
CDPHP Setting Professional Modifier None Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | None | $1.91 | $1.91 | $1.91 |
Cigna Setting Facility Modifier None Typical Low $2.04 Median $2.88 Typical High $3.31 | Facility | None | $2.04 | $2.88 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $10.23 | Professional | None | $2.19 | $2.19 | $10.23 |
Emblem Health Setting Facility Modifier None Typical Low $2.04 Median $2.63 Typical High $4.90 | Facility | None | $2.04 | $2.63 | $4.90 |
Emblem Health Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $7.94 | Professional | None | $2.40 | $2.40 | $7.94 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.45 Median $2.63 Typical High $2.63 | Facility | None | $2.45 | $2.63 | $2.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.45 Typical High $2.63 | Professional | None | $2.40 | $2.45 | $2.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.86 Median $2.45 Typical High $4.90 | Facility | None | $1.86 | $2.45 | $4.90 |
MVP Health Care Setting Facility Modifier None Typical Low $2.40 Median $2.82 Typical High $8.91 | Facility | None | $2.40 | $2.82 | $8.91 |
MVP Health Care Setting Professional Modifier None Typical Low $2.29 Median $2.75 Typical High $2.95 | Professional | None | $2.29 | $2.75 | $2.95 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.51 Typical High $5.75 | Professional | None | $2.40 | $2.51 | $5.75 |
Univera Setting Facility Modifier None Typical Low $2.40 Median $2.63 Typical High $3.16 | Facility | None | $2.40 | $2.63 | $3.16 |
Univera Setting Professional Modifier None Typical Low $2.40 Median $2.63 Typical High $4.07 | Professional | None | $2.40 | $2.63 | $4.07 |
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 $0.33 Median $0.33 Typical High $0.33 | Professional | 55 · Aftercare only | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.22 | $0.22 | $0.22 |
Where New York sits
The same service costs 1.9 times more in Wyoming than in South Carolina. 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· 16th of 51
$2.40
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.