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 $1,096.48 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,096.48 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $245.47 | Professional | None | $77.62 | $97.72 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,819.70 | $3,548.13 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $147.91 | Professional | None | $89.13 | $104.71 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $158.49 Typical High $223.87 | Professional | 50 · Both sides | $134.90 | $158.49 | $223.87 |
CDPHP Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $158.49 | Professional | None | $102.33 | $102.33 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $251.19 | Professional | None | $52.48 | $89.13 | $251.19 |
Emblem Health Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $251.19 | Facility | None | $66.07 | $107.15 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $194.98 | Professional | None | $134.90 | $144.54 | $194.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $151.36 | Professional | None | $75.86 | $109.65 | $151.36 |
MVP Health Care Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $269.15 | Professional | None | $147.91 | $158.49 | $269.15 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,981.07 | $10,232.93 |
United Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $199.53 | Professional | None | $54.95 | $95.50 | $199.53 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $93.33 | Facility | None | $45.71 | $45.71 | $93.33 |
Univera Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $151.36 | Professional | None | $63.10 | $109.65 | $151.36 |
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 $38.90 Median $48.98 Typical High $95.50 | Professional | 52 · Reduced service | $38.90 | $48.98 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $19.50 Typical High $38.90 | Professional | 53 · Discontinued | $15.49 | $19.50 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.45 Typical High $28.84 | Professional | 55 · Aftercare only | $11.75 | $14.45 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.77 Typical High $19.05 | Professional | 56 · Pre-op care only | $7.76 | $9.77 | $19.05 |
Where New York sits
The same service costs 8.7 times more in Oklahoma than in Michigan. 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· 46th of 51
$110
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.