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 $1.74 Median $2.24 Typical High $5.01 | Facility | None | $1.74 | $2.24 | $5.01 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.78 | Facility | None | $1.74 | $1.74 | $1.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
CDPHP Setting Professional Modifier None Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | None | $1.45 | $1.45 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $1.48 Median $2.29 Typical High $2.57 | Facility | None | $1.48 | $2.29 | $2.57 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $7.41 | Professional | None | $1.74 | $1.74 | $7.41 |
Emblem Health Setting Facility Modifier None Typical Low $1.62 Median $2.04 Typical High $3.80 | Facility | None | $1.62 | $2.04 | $3.80 |
Emblem Health Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.40 | Professional | None | $1.86 | $1.86 | $2.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.82 | Facility | None | $1.74 | $1.74 | $1.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | None | $1.74 | $1.74 | $1.82 |
MVP Health Care Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $4.07 | Facility | None | $2.00 | $2.00 | $4.07 |
MVP Health Care Setting Professional Modifier None Typical Low $1.48 Median $2.14 Typical High $2.14 | Professional | None | $1.48 | $2.14 | $2.14 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.82 Typical High $2.34 | Professional | None | $1.74 | $1.82 | $2.34 |
Univera Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.82 | Facility | None | $1.74 | $1.74 | $1.82 |
Univera Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.82 | Professional | None | $1.74 | $1.74 | $1.82 |
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 $0.85 Median $0.85 Typical High $0.85 | Professional | 52 · Reduced service | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 53 · Discontinued | $0.34 | $0.34 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.17 |
Where New York sits
The same service costs 1.8 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· 22nd of 51
$1.74
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.