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 $0.79 Median $1.02 Typical High $2.29 | Facility | None | $0.79 | $1.02 | $2.29 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Cigna Setting Facility Modifier None Typical Low $0.87 Median $1.05 Typical High $1.20 | Facility | None | $0.87 | $1.05 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Emblem Health Setting Facility Modifier None Typical Low $0.76 Median $1.20 Typical High $2.51 | Facility | None | $0.76 | $1.20 | $2.51 |
Emblem Health Setting Professional Modifier None Typical Low $1.02 Median $1.20 Typical High $1.20 | Professional | None | $1.02 | $1.20 | $1.20 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.81 | Facility | None | $0.79 | $0.79 | $0.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.81 | Professional | None | $0.79 | $0.79 | $0.81 |
MVP Health Care Setting Facility Modifier None Typical Low $0.98 Median $0.98 Typical High $2.40 | Facility | None | $0.98 | $0.98 | $2.40 |
MVP Health Care Setting Professional Modifier None Typical Low $0.76 Median $0.98 Typical High $0.98 | Professional | None | $0.76 | $0.98 | $0.98 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $1.07 | Professional | None | $0.79 | $0.83 | $1.07 |
Univera Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.81 | Facility | None | $0.79 | $0.79 | $0.81 |
Univera Setting Professional Modifier None Typical Low $0.79 Median $0.81 Typical High $0.81 | Professional | None | $0.79 | $0.81 | $0.81 |
5 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 $0.40 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Highmark BCBS Setting Facility Modifier EC · Anemia drug, other cause Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | EC · Anemia drug, other cause | $1.58 | $1.58 | $1.58 |
Where New York sits
Rates are fairly even across states for this service. 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· 35th of 51
$0.79
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.