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 $0.32 Median $0.32 Typical High $0.81 | Facility | None | $0.32 | $0.32 | $0.81 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.36 | Professional | None | $0.32 | $0.32 | $0.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Professional | None | $0.32 | $0.32 | $0.32 |
Cigna Setting Facility Modifier None Typical Low $0.28 Median $0.38 Typical High $0.49 | Facility | None | $0.28 | $0.38 | $0.49 |
Cigna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $1.17 | Professional | None | $0.32 | $0.32 | $1.17 |
Emblem Health Setting Facility Modifier None Typical Low $0.28 Median $0.35 Typical High $1.00 | Facility | None | $0.28 | $0.35 | $1.00 |
Emblem Health Setting Professional Modifier None Typical Low $0.24 Median $0.28 Typical High $0.32 | Professional | None | $0.24 | $0.28 | $0.32 |
Excellus BCBS Setting Facility Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | None | $0.28 | $0.28 | $0.28 |
MVP Health Care Setting Facility Modifier None Typical Low $0.37 Median $0.37 Typical High $1.62 | Facility | None | $0.37 | $0.37 | $1.62 |
MVP Health Care Setting Professional Modifier None Typical Low $0.28 Median $0.34 Typical High $0.42 | Professional | None | $0.28 | $0.34 | $0.42 |
United Setting Facility Modifier None Typical Low $0.32 Median $0.32 Typical High $0.32 | Facility | None | $0.32 | $0.32 | $0.32 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.38 Typical High $0.87 | Professional | None | $0.28 | $0.38 | $0.87 |
Univera Setting Facility Modifier None Typical Low $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Univera Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.34 | Professional | None | $0.28 | $0.28 | $0.34 |
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 $0.16 Median $0.16 Typical High $0.16 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $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 |
Highmark BCBS Setting Facility Modifier JZ · No drug discarded Typical Low $0.76 Median $0.76 Typical High $0.76 | Facility | JZ · No drug discarded | $0.76 | $0.76 | $0.76 |
Where New York sits
The same service costs 2.8 times more in Texas than in Rhode Island. 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
$0.32
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.