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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $363.08 | Facility | None | $134.90 | $186.21 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $12.88 Median $138.04 Typical High $338.84 | Facility | None | $12.88 | $138.04 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $14.79 | Professional | None | $10.96 | $12.88 | $14.79 |
Excellus BCBS Setting Facility Modifier None Typical Low $12.88 Median $13.18 Typical High $13.18 | Facility | None | $12.88 | $13.18 | $13.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | None | $12.88 | $13.18 | $13.18 |
MVP Health Care Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $27.54 | Facility | None | $3.16 | $3.16 | $27.54 |
MVP Health Care Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $11.75 | Professional | None | $9.55 | $11.75 | $11.75 |
United Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
Univera Setting Facility Modifier None Typical Low $12.88 Median $13.18 Typical High $13.18 | Facility | None | $12.88 | $13.18 | $13.18 |
Univera Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | None | $12.88 | $13.18 | $13.18 |
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 $1.26 Median $1.26 Typical High $1.26 | Professional | 52 · Reduced service | $1.26 | $1.26 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.25 |
Where New York sits
The same service costs 50.1 times more in Massachusetts than in Indiana. 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
$12.88
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.