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 $0.36 Median $0.36 Typical High $0.55 | Facility | None | $0.36 | $0.36 | $0.55 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.37 Typical High $0.51 | Professional | None | $0.36 | $0.37 | $0.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.23 Median $0.23 Typical High $0.24 | Facility | None | $0.23 | $0.23 | $0.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $1.35 | Professional | None | $0.37 | $0.37 | $1.35 |
CDPHP Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | None | $1.10 | $1.10 | $1.10 |
Cigna Setting Facility Modifier None Typical Low $0.41 Median $0.54 Typical High $1.02 | Facility | None | $0.41 | $0.54 | $1.02 |
Cigna Setting Professional Modifier None Typical Low $0.37 Median $0.37 Typical High $1.00 | Professional | None | $0.37 | $0.37 | $1.00 |
Emblem Health Setting Facility Modifier None Typical Low $0.35 Median $0.44 Typical High $0.81 | Facility | None | $0.35 | $0.44 | $0.81 |
Emblem Health Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.46 | Professional | None | $0.40 | $0.40 | $0.46 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.24 Median $0.89 Typical High $0.89 | Facility | None | $0.24 | $0.89 | $0.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.23 Median $0.24 Typical High $0.89 | Professional | None | $0.23 | $0.24 | $0.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.32 Median $0.48 Typical High $1.74 | Facility | None | $0.32 | $0.48 | $1.74 |
MVP Health Care Setting Facility Modifier None Typical Low $0.34 Median $0.40 Typical High $3.16 | Facility | None | $0.34 | $0.40 | $3.16 |
MVP Health Care Setting Professional Modifier None Typical Low $0.43 Median $0.55 Typical High $1.07 | Professional | None | $0.43 | $0.55 | $1.07 |
United Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $0.37 | Facility | None | $0.37 | $0.37 | $0.37 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.24 Typical High $2.00 | Professional | None | $0.23 | $0.24 | $2.00 |
Univera Setting Facility Modifier None Typical Low $0.23 Median $0.89 Typical High $0.89 | Facility | None | $0.23 | $0.89 | $0.89 |
Univera Setting Professional Modifier None Typical Low $0.23 Median $0.68 Typical High $0.89 | Professional | None | $0.23 | $0.68 | $0.89 |
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 $0.19 Median $0.19 Typical High $0.19 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where New York sits
The same service costs 7.8 times more in Texas than in Maryland. 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· 41st of 51
$0.37
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.