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 $8.71 Median $11.22 Typical High $25.12 | Facility | None | $8.71 | $11.22 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.91 | Facility | None | $8.71 | $8.71 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
CDPHP Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $11.48 Typical High $15.85 | Facility | None | $7.94 | $11.48 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Emblem Health Setting Facility Modifier None Typical Low $8.13 Median $10.23 Typical High $31.62 | Facility | None | $8.13 | $10.23 | $31.62 |
Emblem Health Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $9.55 | Professional | None | $8.91 | $8.91 | $9.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
MVP Health Care Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $35.48 | Facility | None | $10.23 | $10.23 | $35.48 |
MVP Health Care Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.71 | Professional | None | $8.32 | $8.32 | $8.71 |
United Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $11.48 | Professional | None | $8.71 | $9.12 | $11.48 |
Univera Setting Facility Modifier None Typical Low $8.71 Median $8.71 Typical High $9.55 | Facility | None | $8.71 | $8.71 | $9.55 |
Univera Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $4.37 Median $4.37 Typical High $4.37 | Professional | 52 · Reduced service | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 53 · Discontinued | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 55 · Aftercare only | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.87 Typical High $0.87 | Professional | 56 · Pre-op care only | $0.87 | $0.87 | $0.87 |
Where New York sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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
$8.71
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.