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 $0.28 Median $0.33 Typical High $0.81 | Facility | None | $0.28 | $0.33 | $0.81 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.33 | Professional | None | $0.28 | $0.28 | $0.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | None | $0.34 | $0.34 | $0.34 |
Cigna Setting Facility Modifier None Typical Low $0.33 Median $0.33 Typical High $85.11 | Facility | None | $0.33 | $0.33 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Emblem Health Setting Facility Modifier None Typical Low $0.42 Median $0.55 Typical High $1.02 | Facility | None | $0.42 | $0.55 | $1.02 |
Emblem Health Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.34 Median $0.34 Typical High $0.50 | Facility | None | $0.34 | $0.34 | $0.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.34 Median $0.41 Typical High $0.50 | Professional | None | $0.34 | $0.41 | $0.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.35 Median $0.46 Typical High $0.89 | Facility | None | $0.35 | $0.46 | $0.89 |
MVP Health Care Setting Facility Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
MVP Health Care Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.28 | Professional | None | $0.06 | $0.06 | $0.28 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.37 | Professional | None | $0.34 | $0.34 | $0.37 |
Univera Setting Facility Modifier None Typical Low $0.34 Median $0.34 Typical High $0.50 | Facility | None | $0.34 | $0.34 | $0.50 |
Univera Setting Professional Modifier None Typical Low $0.34 Median $0.41 Typical High $0.50 | Professional | None | $0.34 | $0.41 | $0.50 |
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 $0.14 Median $0.14 Typical High $0.17 | Professional | 52 · Reduced service | $0.14 | $0.14 | $0.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where New York sits
The same service costs 1.6 times more in Montana than in Michigan. 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· 48th of 51
$0.34
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.