How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3.31 Median $4.17 Typical High $15.14 | Facility | None | $3.31 | $4.17 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $4.17 | Professional | None | $3.31 | $3.31 | $4.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $12.88 | Facility | None | $4.90 | $4.90 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.45 Median $3.39 Typical High $10.47 | Professional | None | $2.45 | $3.39 | $10.47 |
CDPHP Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $6.46 Typical High $7.24 | Facility | None | $3.24 | $6.46 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $23.99 | Professional | None | $2.95 | $2.95 | $23.99 |
Emblem Health Setting Facility Modifier None Typical Low $4.90 Median $8.13 Typical High $17.78 | Facility | None | $4.90 | $8.13 | $17.78 |
Emblem Health Setting Professional Modifier None Typical Low $2.34 Median $2.95 Typical High $14.13 | Professional | None | $2.34 | $2.95 | $14.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $3.02 Median $4.90 Typical High $6.31 | Professional | None | $3.02 | $4.90 | $6.31 |
MVP Health Care Setting Facility Modifier None Typical Low $4.90 Median $8.91 Typical High $25.70 | Facility | None | $4.90 | $8.91 | $25.70 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $10.23 | Professional | None | $3.98 | $3.98 | $10.23 |
United Setting Facility Modifier None Typical Low $4.47 Median $4.90 Typical High $6.17 | Facility | None | $4.47 | $4.90 | $6.17 |
United Setting Professional Modifier None Typical Low $2.09 Median $2.95 Typical High $7.41 | Professional | None | $2.09 | $2.95 | $7.41 |
Univera Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Univera Setting Professional Modifier None Typical Low $3.02 Median $4.90 Typical High $6.31 | Professional | None | $3.02 | $4.90 | $6.31 |
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 $1.66 Median $1.66 Typical High $2.09 | Professional | 52 · Reduced service | $1.66 | $1.66 | $2.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $0.68 Typical High $0.83 | Professional | 53 · Discontinued | $0.68 | $0.68 | $0.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $0.63 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.42 |
Where New York sits
The same service costs 3.6 times more in Mississippi than in Kentucky. 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· 30th of 51
$3.98
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.