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 $2.95 Median $4.37 Typical High $8.51 | Facility | None | $2.95 | $4.37 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.39 | Professional | None | $2.95 | $2.95 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
CDPHP Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $5.37 | Facility | None | $3.02 | $3.02 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $19.05 | Professional | None | $3.63 | $3.63 | $19.05 |
Emblem Health Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $5.89 | Facility | None | $3.63 | $3.63 | $5.89 |
Emblem Health Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | None | $3.63 | $3.63 | $4.47 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.63 Median $3.72 Typical High $3.72 | Facility | None | $3.63 | $3.72 | $3.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | None | $3.63 | $3.72 | $3.72 |
MVP Health Care Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.72 Typical High $4.90 | Professional | None | $3.55 | $3.72 | $4.90 |
Univera Setting Facility Modifier None Typical Low $3.63 Median $3.72 Typical High $3.72 | Facility | None | $3.63 | $3.72 | $3.72 |
Univera Setting Professional Modifier None Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | None | $3.63 | $3.72 | $3.72 |
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 $1.45 Median $1.45 Typical High $1.70 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.68 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.51 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.34 |
Where New York sits
The same service costs 2.0 times more in Alaska than in Oklahoma. 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· 45th 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.