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 $1.38 Median $1.78 Typical High $3.98 | Facility | None | $1.38 | $1.78 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None | $1.41 | $1.41 | $1.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.41 | Facility | None | $1.38 | $1.38 | $1.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $2.04 | Professional | None | $1.41 | $1.41 | $2.04 |
CDPHP Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.17 | Professional | None | $1.17 | $1.17 | $1.17 |
Cigna Setting Facility Modifier None Typical Low $1.23 Median $1.86 Typical High $2.09 | Facility | None | $1.23 | $1.86 | $2.09 |
Cigna Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $5.75 | Professional | None | $1.41 | $1.41 | $5.75 |
Emblem Health Setting Facility Modifier None Typical Low $1.32 Median $1.62 Typical High $3.02 | Facility | None | $1.32 | $1.62 | $3.02 |
Emblem Health Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $2.29 | Professional | None | $1.45 | $1.45 | $2.29 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $3.80 | Facility | None | $1.74 | $1.74 | $3.80 |
MVP Health Care Setting Professional Modifier None Typical Low $1.35 Median $1.78 Typical High $1.78 | Professional | None | $1.35 | $1.78 | $1.78 |
United Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.45 Typical High $2.04 | Professional | None | $1.38 | $1.45 | $2.04 |
Univera Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.45 | Facility | None | $1.38 | $1.38 | $1.45 |
Univera Setting Professional Modifier None Typical Low $0.98 Median $1.38 Typical High $1.38 | Professional | None | $0.98 | $1.38 | $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 $0.71 Median $0.71 Typical High $0.71 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 25th of 51
$1.41
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.