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 $7.59 Median $12.30 Typical High $21.88 | Facility | None | $7.59 | $12.30 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $8.71 | Professional | None | $7.59 | $7.59 | $8.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | None | $9.12 | $9.12 | $10.47 |
CDPHP Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $12.59 Typical High $85.11 | Facility | None | $9.33 | $12.59 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Emblem Health Setting Facility Modifier None Typical Low $10.47 Median $12.02 Typical High $25.70 | Facility | None | $10.47 | $12.02 | $25.70 |
Emblem Health Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Excellus BCBS Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Facility | None | $9.12 | $9.12 | $10.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | None | $9.12 | $9.12 | $10.47 |
MVP Health Care Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
MVP Health Care Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.49 | Professional | None | $13.18 | $13.18 | $13.49 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $9.77 | Professional | None | $8.71 | $9.12 | $9.77 |
Univera Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Facility | None | $9.12 | $9.12 | $10.47 |
Univera Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.47 | Professional | None | $9.12 | $9.12 | $10.47 |
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 $3.80 Median $3.80 Typical High $4.37 | Professional | 52 · Reduced service | $3.80 | $3.80 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.51 Typical High $1.78 | Professional | 53 · Discontinued | $1.51 | $1.51 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.12 Typical High $1.32 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.76 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.76 | $0.76 | $0.87 |
Where New York sits
The same service costs 1.8 times more in Alaska than in Montana. 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· 45th of 51
$9.12
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.