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 $0.34 Median $0.79 Typical High $0.85 | Facility | None | $0.34 | $0.79 | $0.85 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.85 | Professional | None | $0.54 | $0.54 | $0.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.98 Median $1.55 Typical High $4.27 | Professional | None | $0.98 | $1.55 | $4.27 |
Cigna Setting Facility Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Facility | None | $1.62 | $1.62 | $1.62 |
Cigna Setting Professional Modifier None Typical Low $0.47 Median $0.85 Typical High $4.79 | Professional | None | $0.47 | $0.85 | $4.79 |
Emblem Health Setting Facility Modifier None Typical Low $1.26 Median $2.82 Typical High $4.79 | Facility | None | $1.26 | $2.82 | $4.79 |
Emblem Health Setting Professional Modifier None Typical Low $0.63 Median $1.26 Typical High $3.39 | Professional | None | $0.63 | $1.26 | $3.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.78 Median $0.91 Typical High $1.10 | Professional | None | $0.78 | $0.91 | $1.10 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $1.00 | Facility | None | $0.79 | $0.79 | $1.00 |
United Setting Professional Modifier None Typical Low $0.85 Median $1.26 Typical High $2.34 | Professional | None | $0.85 | $1.26 | $2.34 |
Univera Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
Univera Setting Professional Modifier None Typical Low $0.55 Median $0.91 Typical High $1.10 | Professional | None | $0.55 | $0.91 | $1.10 |
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 $0.27 Median $0.27 Typical High $0.43 | Professional | 52 · Reduced service | $0.27 | $0.27 | $0.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.11 Typical High $0.17 | Professional | 53 · Discontinued | $0.11 | $0.11 | $0.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.13 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.09 |
Where New York sits
The same service costs 104.7 times more in Wyoming than in Connecticut. 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· 24th of 51
$1.07
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.