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 $2.24 Median $2.88 Typical High $6.46 | Facility | None | $2.24 | $2.88 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.29 | Facility | None | $2.24 | $2.24 | $2.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | None | $2.29 | $2.29 | $2.29 |
CDPHP Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $2.40 Median $2.95 Typical High $3.47 | Facility | None | $2.40 | $2.95 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $9.33 | Professional | None | $2.29 | $2.29 | $9.33 |
Emblem Health Setting Facility Modifier None Typical Low $2.19 Median $2.75 Typical High $5.13 | Facility | None | $2.19 | $2.75 | $5.13 |
Emblem Health Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $3.63 | Professional | None | $2.51 | $2.51 | $3.63 |
Excellus BCBS Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.29 | Facility | None | $2.24 | $2.24 | $2.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.29 | Professional | None | $2.24 | $2.24 | $2.29 |
MVP Health Care Setting Facility Modifier None Typical Low $2.88 Median $2.88 Typical High $5.89 | Facility | None | $2.88 | $2.88 | $5.89 |
MVP Health Care Setting Professional Modifier None Typical Low $2.19 Median $2.75 Typical High $3.02 | Professional | None | $2.19 | $2.75 | $3.02 |
United Setting Facility Modifier None Typical Low $2.29 Median $2.29 Typical High $2.29 | Facility | None | $2.29 | $2.29 | $2.29 |
United Setting Professional Modifier None Typical Low $2.24 Median $2.34 Typical High $3.39 | Professional | None | $2.24 | $2.34 | $3.39 |
Univera Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.34 | Facility | None | $2.24 | $2.24 | $2.34 |
Univera Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.29 | Professional | None | $2.24 | $2.24 | $2.29 |
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 $1.15 Median $1.15 Typical High $1.15 | Professional | 52 · Reduced service | $1.15 | $1.15 | $1.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 53 · Discontinued | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.23 | $0.23 | $0.23 |
Where New York sits
The same service costs 3311.3 times more in Alabama than in Mississippi. 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· 41st of 51
$2.29
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.