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 $12.88 Median $14.13 Typical High $42.66 | Facility | None | $12.88 | $14.13 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.80 | Professional | None | $12.88 | $12.88 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $15.85 | Professional | None | $12.88 | $12.88 | $15.85 |
CDPHP Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $16.98 Typical High $23.44 | Facility | None | $11.22 | $16.98 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $63.10 | Professional | None | $12.88 | $12.88 | $63.10 |
Emblem Health Setting Facility Modifier None Typical Low $12.30 Median $15.49 Typical High $28.84 | Facility | None | $12.30 | $15.49 | $28.84 |
Emblem Health Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $30.90 | Professional | None | $14.13 | $14.13 | $30.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $15.49 | Facility | None | $14.79 | $14.79 | $15.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | None | $14.79 | $14.79 | $15.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
MVP Health Care Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $47.86 | Facility | None | $16.22 | $16.22 | $47.86 |
MVP Health Care Setting Professional Modifier None Typical Low $11.48 Median $22.39 Typical High $22.39 | Professional | None | $11.48 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $22.91 | Professional | None | $14.79 | $15.85 | $22.91 |
Univera Setting Facility Modifier None Typical Low $14.79 Median $14.79 Typical High $15.49 | Facility | None | $14.79 | $14.79 | $15.49 |
Univera Setting Professional Modifier None Typical Low $7.08 Median $14.79 Typical High $15.49 | Professional | None | $7.08 | $14.79 | $15.49 |
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 $6.46 Median $6.46 Typical High $6.46 | Professional | 52 · Reduced service | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 53 · Discontinued | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 55 · Aftercare only | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Where New York sits
The same service costs 2.0 times more in South Carolina than in Kentucky. 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· 38th of 51
$14.13
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.