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 $5.01 Median $5.37 Typical High $12.02 | Facility | None | $5.01 | $5.37 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Ambetter Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.25 | Professional | None | $4.90 | $4.90 | $5.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
CDPHP Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $7.59 Typical High $47.86 | Facility | None | $5.75 | $7.59 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Emblem Health Setting Facility Modifier None Typical Low $5.01 Median $6.03 Typical High $11.22 | Facility | None | $5.01 | $6.03 | $11.22 |
Emblem Health Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | None | $5.50 | $5.50 | $5.75 |
Excellus BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $5.01 | Facility | None | $4.90 | $4.90 | $5.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.01 | Professional | None | $4.90 | $4.90 | $5.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $9.12 Median $17.38 Typical High $19.50 | Facility | None | $9.12 | $17.38 | $19.50 |
MVP Health Care Setting Facility Modifier None Typical Low $7.76 Median $8.91 Typical High $35.48 | Facility | None | $7.76 | $8.91 | $35.48 |
MVP Health Care Setting Professional Modifier None Typical Low $7.24 Median $9.55 Typical High $9.55 | Professional | None | $7.24 | $9.55 | $9.55 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.13 Typical High $6.61 | Professional | None | $4.90 | $5.13 | $6.61 |
Univera Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $5.25 | Facility | None | $4.90 | $4.90 | $5.25 |
Univera Setting Professional Modifier None Typical Low $4.90 Median $5.01 Typical High $5.01 | Professional | None | $4.90 | $5.01 | $5.01 |
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 $2.63 Median $2.63 Typical High $2.63 | Professional | 52 · Reduced service | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 55 · Aftercare only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Highmark BCBS Setting Professional Modifier JZ · No drug discarded Typical Low $5.62 Median $6.92 Typical High $16.60 | Professional | JZ · No drug discarded | $5.62 | $6.92 | $16.60 |
Where New York sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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· 31st of 51
$5.25
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.