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 $7.76 Median $12.30 Typical High $22.39 | Facility | None | $7.76 | $12.30 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $25.12 | Professional | None | $12.30 | $12.30 | $25.12 |
CDPHP Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $17.78 Typical High $31.62 | Facility | None | $13.49 | $17.78 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $48.98 | Professional | None | $12.30 | $12.30 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $11.48 Median $14.79 Typical High $27.54 | Facility | None | $11.48 | $14.79 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $10.72 Median $13.49 Typical High $81.28 | Professional | None | $10.72 | $13.49 | $81.28 |
Excellus BCBS Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.94 | Facility | None | $7.76 | $7.76 | $7.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | None | $7.76 | $7.94 | $7.94 |
MVP Health Care Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $117.49 | Facility | None | $18.62 | $18.62 | $117.49 |
MVP Health Care Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $60.26 | Professional | None | $20.42 | $20.42 | $60.26 |
United Setting Professional Modifier None Typical Low $3.09 Median $7.76 Typical High $14.45 | Professional | None | $3.09 | $7.76 | $14.45 |
Univera Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $9.33 | Facility | None | $7.76 | $7.76 | $9.33 |
Univera Setting Professional Modifier None Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | None | $7.76 | $7.94 | $7.94 |
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 $6.17 Median $6.17 Typical High $6.17 | Professional | 52 · Reduced service | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 53 · Discontinued | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.23 |
Where New York sits
The same service costs 6.3 times more in Wyoming 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· 47th of 51
$10.72
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.