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 $1.58 Median $1.58 Typical High $3.24 | Facility | None | $1.58 | $1.58 | $3.24 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.66 | Professional | None | $1.58 | $1.58 | $1.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $6.92 | Professional | None | $1.58 | $1.58 | $6.92 |
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 $1.74 Median $2.29 Typical High $3.16 | Facility | None | $1.74 | $2.29 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $6.92 | Professional | None | $1.58 | $1.58 | $6.92 |
Emblem Health Setting Facility Modifier None Typical Low $1.51 Median $1.91 Typical High $3.55 | Facility | None | $1.51 | $1.91 | $3.55 |
Emblem Health Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $4.17 | Professional | None | $1.74 | $1.74 | $4.17 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.62 | Facility | None | $1.55 | $1.55 | $1.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.62 | Professional | None | $1.55 | $1.55 | $1.62 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.93 Median $1.78 Typical High $4.37 | Facility | None | $0.93 | $1.78 | $4.37 |
MVP Health Care Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $7.08 | Facility | None | $2.29 | $2.29 | $7.08 |
MVP Health Care Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $3.98 | Professional | None | $2.29 | $2.29 | $3.98 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.62 Typical High $4.37 | Professional | None | $1.55 | $1.62 | $4.37 |
Univera Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.86 | Facility | None | $1.55 | $1.55 | $1.86 |
Univera Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $3.39 | Professional | None | $1.55 | $1.55 | $3.39 |
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 $0.79 Median $0.79 Typical High $0.79 | Professional | 52 · Reduced service | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 53 · Discontinued | $0.32 | $0.32 | $0.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | 55 · Aftercare only | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.16 | $0.16 | $0.16 |
Where New York sits
The same service costs 3.3 times more in Texas than in Maryland. 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· 46th of 51
$1.58
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.