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 $3.55 Median $4.57 Typical High $10.47 | Facility | None | $3.55 | $4.57 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Facility | None | $3.55 | $3.55 | $3.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $5.62 | Professional | None | $3.72 | $3.72 | $5.62 |
CDPHP Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $4.90 Typical High $5.62 | Facility | None | $3.47 | $4.90 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $15.14 | Professional | None | $3.72 | $3.72 | $15.14 |
Emblem Health Setting Facility Modifier None Typical Low $3.47 Median $4.47 Typical High $8.32 | Facility | None | $3.47 | $4.47 | $8.32 |
Emblem Health Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $5.13 | Professional | None | $4.07 | $4.07 | $5.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Facility | None | $3.55 | $3.55 | $3.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | None | $3.55 | $3.55 | $3.72 |
MVP Health Care Setting Facility Modifier None Typical Low $4.68 Median $4.68 Typical High $8.51 | Facility | None | $4.68 | $4.68 | $8.51 |
MVP Health Care Setting Professional Modifier None Typical Low $3.39 Median $4.57 Typical High $4.57 | Professional | None | $3.39 | $4.57 | $4.57 |
United Setting Facility Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $3.55 Median $3.80 Typical High $4.90 | Professional | None | $3.55 | $3.80 | $4.90 |
Univera Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $3.80 | Facility | None | $3.55 | $3.55 | $3.80 |
Univera Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.72 | Professional | None | $3.55 | $3.55 | $3.72 |
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 $1.86 Median $1.86 Typical High $1.86 | Professional | 52 · Reduced service | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.74 Median $0.74 Typical High $0.74 | Professional | 53 · Discontinued | $0.74 | $0.74 | $0.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.37 |
Where New York sits
The same service costs 1.9 times more in Alaska 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· 42nd of 51
$3.72
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.