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 $5.50 Median $8.13 Typical High $15.85 | Facility | None | $5.50 | $8.13 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $6.76 | Professional | None | $5.50 | $5.50 | $6.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $0.71 Median $0.71 Typical High $11.75 | Facility | None | $0.71 | $0.71 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
Emblem Health Setting Facility Modifier None Typical Low $0.72 Median $1.00 Typical High $2.04 | Facility | None | $0.72 | $1.00 | $2.04 |
Emblem Health Setting Professional Modifier None Typical Low $0.58 Median $1.00 Typical High $1.23 | Professional | None | $0.58 | $1.00 | $1.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $1.00 Median $1.05 Typical High $1.05 | Facility | None | $1.00 | $1.05 | $1.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.05 | Professional | None | $1.00 | $1.00 | $1.05 |
MVP Health Care Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
MVP Health Care Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
United Setting Professional Modifier None Typical Low $2.63 Median $6.61 Typical High $7.24 | Professional | None | $2.63 | $6.61 | $7.24 |
Univera Setting Facility Modifier None Typical Low $1.00 Median $1.05 Typical High $1.26 | Facility | None | $1.00 | $1.05 | $1.26 |
Univera Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.05 | Professional | None | $1.00 | $1.00 | $1.05 |
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 $2.69 Median $2.69 Typical High $3.39 | Professional | 52 · Reduced service | $2.69 | $2.69 | $3.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.10 Median $1.10 Typical High $1.35 | Professional | 53 · Discontinued | $1.10 | $1.10 | $1.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $1.00 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.68 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.68 |
Where New York sits
The same service costs 15.5 times more in Alaska than in Hawaii. 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· 43rd of 51
$5.50
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.