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 $11.22 Median $11.48 Typical High $23.99 | Facility | None | $11.22 | $11.48 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.48 Typical High $12.59 | Professional | None | $11.22 | $11.48 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $12.02 | Facility | None | $11.75 | $11.75 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $23.44 | Professional | None | $11.48 | $11.48 | $23.44 |
CDPHP Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $15.14 Typical High $16.98 | Facility | None | $12.30 | $15.14 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $48.98 | Professional | None | $11.48 | $11.48 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $10.72 Median $13.49 Typical High $25.12 | Facility | None | $10.72 | $13.49 | $25.12 |
Emblem Health Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $17.78 | Professional | None | $12.30 | $12.30 | $17.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
Highmark BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
MVP Health Care Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $30.20 | Facility | None | $16.98 | $16.98 | $30.20 |
MVP Health Care Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $18.20 | Professional | None | $12.88 | $16.60 | $18.20 |
United Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $11.75 Median $12.30 Typical High $17.78 | Professional | None | $11.75 | $12.30 | $17.78 |
Univera Setting Facility Modifier None Typical Low $11.75 Median $11.75 Typical High $12.30 | Facility | None | $11.75 | $11.75 | $12.30 |
Univera Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | None | $11.75 | $11.75 | $11.75 |
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 $5.62 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Where New York sits
The same service costs 1.8 times more in Alaska than in Georgia. 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
$11.75
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.