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 $8.91 Median $17.38 Typical High $40.74 | Facility | None | $8.91 | $17.38 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $17.78 Typical High $23.44 | Professional | None | $8.91 | $17.78 | $23.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $17.38 Typical High $30.90 | Professional | None | $14.13 | $17.38 | $30.90 |
CDPHP Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $23.99 | Professional | None | $12.30 | $12.30 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $12.88 Typical High $38.02 | Professional | None | $6.46 | $12.88 | $38.02 |
Emblem Health Setting Facility Modifier None Typical Low $8.71 Median $15.85 Typical High $33.11 | Facility | None | $8.71 | $15.85 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $15.49 | Professional | None | $4.27 | $5.01 | $15.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.75 Median $16.22 Typical High $25.70 | Professional | None | $11.75 | $16.22 | $25.70 |
MVP Health Care Setting Facility Modifier None Typical Low $7.94 Median $8.71 Typical High $17.38 | Facility | None | $7.94 | $8.71 | $17.38 |
MVP Health Care Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $42.66 | Professional | None | $12.02 | $12.02 | $42.66 |
United Setting Professional Modifier None Typical Low $7.59 Median $15.49 Typical High $35.48 | Professional | None | $7.59 | $15.49 | $35.48 |
Univera Setting Facility Modifier None Typical Low $6.31 Median $15.49 Typical High $87.10 | Facility | None | $6.31 | $15.49 | $87.10 |
Univera Setting Professional Modifier None Typical Low $11.75 Median $16.22 Typical High $25.70 | Professional | None | $11.75 | $16.22 | $25.70 |
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 $4.47 Median $8.71 Typical High $11.75 | Professional | 52 · Reduced service | $4.47 | $8.71 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.78 Median $3.55 Typical High $4.68 | Professional | 53 · Discontinued | $1.78 | $3.55 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.32 Median $2.63 Typical High $3.55 | Professional | 55 · Aftercare only | $1.32 | $2.63 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $1.78 Typical High $2.34 | Professional | 56 · Pre-op care only | $0.87 | $1.78 | $2.34 |
Where New York sits
The same service costs 3.2 times more in Wisconsin than in Nebraska. 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· 36th of 51
$17.38
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.