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 $1.95 Median $2.51 Typical High $5.75 | Facility | None | $1.95 | $2.51 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $2.04 | Facility | None | $1.95 | $1.95 | $2.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.57 | Professional | None | $2.09 | $2.09 | $2.57 |
CDPHP Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $2.75 Typical High $3.09 | Facility | None | $1.70 | $2.75 | $3.09 |
Cigna Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $8.32 | Professional | None | $2.09 | $2.09 | $8.32 |
Emblem Health Setting Facility Modifier None Typical Low $1.95 Median $2.40 Typical High $4.47 | Facility | None | $1.95 | $2.40 | $4.47 |
Emblem Health Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.51 | Professional | None | $2.14 | $2.14 | $2.51 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $2.04 | Facility | None | $1.95 | $1.95 | $2.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | None | $1.95 | $1.95 | $2.04 |
MVP Health Care Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $4.07 | Facility | None | $2.45 | $2.45 | $4.07 |
MVP Health Care Setting Professional Modifier None Typical Low $1.45 Median $2.29 Typical High $2.29 | Professional | None | $1.45 | $2.29 | $2.29 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.09 Typical High $2.63 | Professional | None | $1.86 | $2.09 | $2.63 |
Univera Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $2.04 | Facility | None | $1.95 | $1.95 | $2.04 |
Univera Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.04 | Professional | None | $1.95 | $1.95 | $2.04 |
5 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 $1.05 Median $1.05 Typical High $1.05 | Professional | 52 · Reduced service | $1.05 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 53 · Discontinued | $0.42 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.55 Median $1.55 Typical High $1.55 | Professional | 54 · Surgery only | $1.55 | $1.55 | $1.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.31 Typical High $0.31 | Professional | 55 · Aftercare only | $0.31 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 56 · Pre-op care only | $0.21 | $0.21 | $0.21 |
Where New York sits
The same service costs 1.6 times more in Alaska than in Iowa. 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· 21st of 51
$2.09
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.