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 $1.32 Median $1.70 Typical High $3.80 | Facility | None | $1.32 | $1.70 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.35 | Facility | None | $1.32 | $1.32 | $1.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $2.04 | Professional | None | $1.32 | $1.32 | $2.04 |
CDPHP Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Cigna Setting Facility Modifier None Typical Low $1.15 Median $1.74 Typical High $2.00 | Facility | None | $1.15 | $1.74 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $5.62 | Professional | None | $1.32 | $1.32 | $5.62 |
Emblem Health Setting Facility Modifier None Typical Low $1.26 Median $1.51 Typical High $2.82 | Facility | None | $1.26 | $1.51 | $2.82 |
Emblem Health Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $2.24 | Professional | None | $1.38 | $1.38 | $2.24 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.38 | Facility | None | $1.32 | $1.32 | $1.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.38 | Professional | None | $1.32 | $1.32 | $1.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $3.89 | Facility | None | $1.62 | $1.62 | $3.89 |
MVP Health Care Setting Professional Modifier None Typical Low $1.17 Median $1.62 Typical High $1.62 | Professional | None | $1.17 | $1.62 | $1.62 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.41 Typical High $2.00 | Professional | None | $1.32 | $1.41 | $2.00 |
Univera Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.38 | Facility | None | $1.32 | $1.32 | $1.38 |
Univera Setting Professional Modifier None Typical Low $0.93 Median $1.32 Typical High $1.38 | Professional | None | $0.93 | $1.32 | $1.38 |
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 $0.68 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.68 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.27 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 56 · Pre-op care only | $0.13 | $0.13 | $0.13 |
Where New York sits
The same service costs 1.5 times more in Alaska than in Virginia. 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· 48th of 51
$1.32
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.