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 $3.24 Median $4.17 Typical High $9.33 | Facility | None | $3.24 | $4.17 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.31 | Facility | None | $3.24 | $3.24 | $3.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
CDPHP Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Facility Modifier None Typical Low $3.39 Median $4.27 Typical High $4.90 | Facility | None | $3.39 | $4.27 | $4.90 |
Cigna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $13.80 | Professional | None | $3.24 | $3.24 | $13.80 |
Emblem Health Setting Facility Modifier None Typical Low $3.02 Median $3.89 Typical High $7.24 | Facility | None | $3.02 | $3.89 | $7.24 |
Emblem Health Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | None | $3.55 | $3.55 | $3.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | None | $3.24 | $3.24 | $3.39 |
MVP Health Care Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $6.46 | Facility | None | $4.17 | $4.17 | $6.46 |
MVP Health Care Setting Professional Modifier None Typical Low $3.24 Median $4.07 Typical High $4.68 | Professional | None | $3.24 | $4.07 | $4.68 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $4.47 | Professional | None | $3.24 | $3.47 | $4.47 |
Univera Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Univera Setting Professional Modifier None Typical Low $1.07 Median $3.24 Typical High $3.39 | Professional | None | $1.07 | $3.24 | $3.39 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 54 · Surgery only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.49 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.32 | $0.32 | $0.32 |
Where New York sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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
$3.24
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.