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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | None | $19.05 | $19.95 | $19.95 |
CDPHP Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $165.96 Typical High $186.21 | Facility | None | $18.62 | $165.96 | $186.21 |
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 $22.39 Median $138.04 Typical High $501.19 | Facility | None | $22.39 | $138.04 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $19.05 Median $22.39 Typical High $26.30 | Professional | None | $19.05 | $22.39 | $26.30 |
Excellus BCBS Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Facility | None | $22.39 | $23.44 | $23.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | None | $22.39 | $23.44 | $23.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
MVP Health Care Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $48.98 | Facility | None | $26.92 | $26.92 | $48.98 |
MVP Health Care Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | None | $20.42 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $165.96 | Professional | None | $120.23 | $125.89 | $165.96 |
Univera Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Facility | None | $22.39 | $23.44 | $23.44 |
Univera Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | None | $22.39 | $23.44 | $23.44 |
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 $10.00 Median $10.00 Typical High $10.00 | Professional | 52 · Reduced service | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | 53 · Discontinued | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.00 |
Where New York sits
The same service costs 6.3 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· 43rd of 51
$22.39
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.