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 $0.39 Median $0.48 Typical High $1.12 | Facility | None | $0.39 | $0.48 | $1.12 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.45 | Professional | None | $0.39 | $0.39 | $0.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.47 | Professional | None | $0.47 | $0.47 | $0.47 |
Cigna Setting Facility Modifier None Typical Low $0.48 Median $0.58 Typical High $85.11 | Facility | None | $0.48 | $0.58 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Emblem Health Setting Facility Modifier None Typical Low $2.04 Median $2.04 Typical High $3.31 | Facility | None | $2.04 | $2.04 | $3.31 |
Emblem Health Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | None | $2.04 | $2.04 | $2.04 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.47 Median $0.47 Typical High $2.04 | Facility | None | $0.47 | $0.47 | $2.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $2.04 | Professional | None | $0.47 | $0.47 | $2.04 |
MVP Health Care Setting Facility Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Facility | None | $1.02 | $1.02 | $1.02 |
MVP Health Care Setting Professional Modifier None Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | None | $0.52 | $0.52 | $0.52 |
United Setting Professional Modifier None Typical Low $0.44 Median $0.47 Typical High $0.51 | Professional | None | $0.44 | $0.47 | $0.51 |
Univera Setting Facility Modifier None Typical Low $0.47 Median $0.47 Typical High $2.04 | Facility | None | $0.47 | $0.47 | $2.04 |
Univera Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $2.04 | Professional | None | $0.47 | $0.47 | $2.04 |
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 $0.20 Median $0.20 Typical High $0.23 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.09 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Where New York sits
The same service costs 2.3 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· 44th of 51
$0.47
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.