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 $2.88 Median $2.88 Typical High $7.08 | Facility | None | $2.88 | $2.88 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.02 | Professional | None | $2.88 | $2.88 | $3.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.39 | Professional | None | $2.88 | $2.88 | $3.39 |
CDPHP Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $4.17 Typical High $4.68 | Facility | None | $3.16 | $4.17 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Emblem Health Setting Facility Modifier None Typical Low $2.69 Median $3.47 Typical High $6.46 | Facility | None | $2.69 | $3.47 | $6.46 |
Emblem Health Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Excellus BCBS Setting Facility Modifier None Typical Low $3.31 Median $8.32 Typical High $8.32 | Facility | None | $3.31 | $8.32 | $8.32 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.31 | Professional | None | $3.24 | $3.24 | $3.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $3.39 Median $7.41 Typical High $20.89 | Facility | None | $3.39 | $7.41 | $20.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
MVP Health Care Setting Facility Modifier None Typical Low $3.24 Median $3.80 Typical High $21.88 | Facility | None | $3.24 | $3.80 | $21.88 |
MVP Health Care Setting Professional Modifier None Typical Low $3.16 Median $3.55 Typical High $3.55 | Professional | None | $3.16 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $4.37 | Professional | None | $3.09 | $3.31 | $4.37 |
Univera Setting Facility Modifier None Typical Low $3.24 Median $8.32 Typical High $8.32 | Facility | None | $3.24 | $8.32 | $8.32 |
Univera Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.31 | Professional | None | $3.24 | $3.24 | $3.31 |
5 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 $1.45 Median $1.45 Typical High $1.45 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.58 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.43 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $2.75 Median $3.24 Typical High $3.24 | Professional | JZ · No drug discarded | $2.75 | $3.24 | $3.24 |
Where New York sits
The same service costs 3.1 times more in Wyoming than in Delaware. 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· 27th of 51
$3.02
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.