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 $10.47 Median $18.62 Typical High $4,168.69 | Facility | None | $10.47 | $18.62 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $14.45 Typical High $19.50 | Professional | None | $12.30 | $14.45 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.23 Median $12.02 Typical High $28.84 | Professional | None | $10.23 | $12.02 | $28.84 |
CDPHP Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $21.38 | Professional | None | $17.38 | $17.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $15.85 Typical High $1,479.11 | Facility | None | $8.32 | $15.85 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $15.85 Typical High $56.23 | Professional | None | $12.59 | $15.85 | $56.23 |
Emblem Health Setting Facility Modifier None Typical Low $12.30 Median $27.54 Typical High $46.77 | Facility | None | $12.30 | $27.54 | $46.77 |
Emblem Health Setting Professional Modifier None Typical Low $17.38 Median $20.89 Typical High $58.88 | Professional | None | $17.38 | $20.89 | $58.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.77 Median $14.13 Typical High $20.89 | Professional | None | $9.77 | $14.13 | $20.89 |
MVP Health Care Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $39.81 | Professional | None | $19.50 | $19.50 | $39.81 |
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 $10.47 Median $18.62 Typical High $38.90 | Professional | None | $10.47 | $18.62 | $38.90 |
Univera Setting Facility Modifier None Typical Low $8.71 Median $13.80 Typical High $48.98 | Facility | None | $8.71 | $13.80 | $48.98 |
Univera Setting Professional Modifier None Typical Low $9.12 Median $12.88 Typical High $19.50 | Professional | None | $9.12 | $12.88 | $19.50 |
6 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 $6.31 Median $7.24 Typical High $9.33 | Professional | 52 · Reduced service | $6.31 | $7.24 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.88 Typical High $3.72 | Professional | 53 · Discontinued | $2.51 | $2.88 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.33 Median $10.96 Typical High $13.80 | Professional | 54 · Surgery only | $9.33 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.19 Typical High $2.82 | Professional | 55 · Aftercare only | $1.91 | $2.19 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.45 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.26 | $1.45 | $1.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.72 Typical High $15.14 | Professional | 53 · Discontinued | $7.94 | $10.72 | $15.14 |
Where New York sits
The same service costs 3.5 times more in Alaska than in New York. 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· 51st of 51
$13.80
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.