How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $0.12 Median $0.18 Typical High $0.35 | Facility | None | $0.12 | $0.18 | $0.35 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.15 | Professional | None | $0.12 | $0.12 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.21 Median $0.26 Typical High $0.30 | Professional | None | $0.21 | $0.26 | $0.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.72 Typical High $1.00 | Professional | None | $0.28 | $0.72 | $1.00 |
Univera Setting Facility Modifier None Typical Low $0.13 Median $0.15 Typical High $0.15 | Facility | None | $0.13 | $0.15 | $0.15 |
Univera Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
3 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 $0.06 Median $0.06 Typical High $0.07 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where New York sits
The same service costs 12.9 times more in Kansas than in Michigan. 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· 29th of 51
$0.27
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.