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 $3.02 Median $4.27 Typical High $9.55 | Facility | None | $3.02 | $4.27 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.39 | Professional | None | $3.02 | $3.02 | $3.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Facility | None | $3.24 | $3.24 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
CDPHP Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $3.31 Median $4.37 Typical High $19.50 | Facility | None | $3.31 | $4.37 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $13.80 | Professional | None | $3.02 | $3.02 | $13.80 |
Emblem Health Setting Facility Modifier None Typical Low $2.88 Median $3.63 Typical High $6.76 | Facility | None | $2.88 | $3.63 | $6.76 |
Emblem Health Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $22.91 | Professional | None | $3.31 | $3.31 | $22.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.59 | Facility | None | $3.24 | $3.24 | $7.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $7.59 | Professional | None | $3.24 | $3.24 | $7.59 |
MVP Health Care Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $39.81 | Facility | None | $6.92 | $6.92 | $39.81 |
MVP Health Care Setting Professional Modifier None Typical Low $6.17 Median $8.51 Typical High $11.48 | Professional | None | $6.17 | $8.51 | $11.48 |
United Setting Facility Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Facility | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.47 Typical High $6.92 | Professional | None | $3.24 | $3.47 | $6.92 |
Univera Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $7.59 | Facility | None | $3.24 | $3.24 | $7.59 |
Univera Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $7.59 | Professional | None | $3.24 | $3.24 | $7.59 |
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 $1.51 Median $1.51 Typical High $1.51 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 53 · Discontinued | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 55 · Aftercare only | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where New York sits
The same service costs 6.0 times more in Wyoming than in Georgia. 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· 37th 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.