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 $416.87 Median $446.68 Typical High $1,288.25 | Facility | None | $416.87 | $446.68 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $954.99 | Professional | None | $416.87 | $537.03 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $954.99 | Professional | None | $354.81 | $416.87 | $954.99 |
CDPHP Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,778.28 Typical High $3,981.07 | Facility | None | $691.83 | $1,778.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,862.09 | Professional | None | $524.81 | $676.08 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $512.86 Typical High $1,621.81 | Facility | None | $426.58 | $512.86 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $891.25 | Professional | None | $549.54 | $758.58 | $891.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $691.83 | Professional | None | $363.08 | $457.09 | $691.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $3,235.94 Typical High $4,365.16 | Facility | None | $707.95 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $1,202.26 | Professional | None | $346.74 | $346.74 | $1,202.26 |
United Setting Facility Modifier None Typical Low $512.86 Median $1,698.24 Typical High $6,165.95 | Facility | None | $512.86 | $1,698.24 | $6,165.95 |
United Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $1,148.15 | Professional | None | $338.84 | $512.86 | $1,148.15 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $524.81 Typical High $1,071.52 | Facility | None | $363.08 | $524.81 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $676.08 | Professional | None | $363.08 | $501.19 | $676.08 |
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 $208.93 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $53.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $323.59 Typical High $562.34 | Professional | 53 · Discontinued | $234.42 | $323.59 | $562.34 |
Where New York sits
The same service costs 3.1 times more in Alaska than in Indiana. 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· 50th of 51
$457
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.