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 $40.74 Median $69.18 Typical High $177.83 | Facility | None | $40.74 | $69.18 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $83.18 | Professional | None | $47.86 | $69.18 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $138.04 | Professional | None | $69.18 | $83.18 | $138.04 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | None | $67.61 | $67.61 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $87.10 Typical High $158.49 | Facility | None | $51.29 | $87.10 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $223.87 | Professional | None | $48.98 | $81.28 | $223.87 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $169.82 | Facility | None | $44.67 | $53.70 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $147.91 | Professional | None | $87.10 | $93.33 | $147.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $109.65 | Professional | None | $51.29 | $69.18 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $173.78 | Professional | None | $50.12 | $50.12 | $173.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $42.66 Median $75.86 Typical High $162.18 | Professional | None | $42.66 | $75.86 | $162.18 |
Univera Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $165.96 | Facility | None | $34.67 | $54.95 | $165.96 |
Univera Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $100.00 | Professional | None | $47.86 | $69.18 | $100.00 |
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 $23.99 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $23.99 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $9.55 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $7.24 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $4.79 | $6.92 | $7.59 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $77.62 | Professional | 53 · Discontinued | $35.48 | $47.86 | $77.62 |
Where New York sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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· 25th of 51
$79.43
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.