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 $56.23 Median $60.26 Typical High $79.43 | Facility | None | $56.23 | $60.26 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $79.43 | Professional | None | $56.23 | $60.26 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $112.20 Typical High $263.03 | Professional | None | $38.90 | $112.20 | $263.03 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $83.18 Typical High $177.83 | Facility | None | $56.23 | $83.18 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $208.93 | Professional | None | $54.95 | $109.65 | $208.93 |
Emblem Health Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $281.84 | Facility | None | $79.43 | $100.00 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $134.90 | Professional | None | $60.26 | $89.13 | $134.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $100.00 | Professional | None | $58.88 | $85.11 | $100.00 |
MVP Health Care Setting Facility Modifier None Typical Low $13.80 Median $125.89 Typical High $257.04 | Facility | None | $13.80 | $125.89 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $229.09 | Professional | None | $72.44 | $83.18 | $229.09 |
United Setting Facility Modifier None Typical Low $338.84 Median $398.11 Typical High $489.78 | Facility | None | $338.84 | $398.11 | $489.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $147.91 | Professional | None | $41.69 | $58.88 | $147.91 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $58.88 Typical High $112.20 | Facility | None | $54.95 | $58.88 | $112.20 |
Univera Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $91.20 | Professional | None | $58.88 | $85.11 | $91.20 |
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 $28.18 Median $30.20 Typical High $39.81 | Professional | 52 · Reduced service | $28.18 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.02 Typical High $15.85 | Professional | 53 · Discontinued | $11.22 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $9.12 Typical High $12.02 | Professional | 55 · Aftercare only | $8.51 | $9.12 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.03 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.62 | $6.03 | $7.94 |
Where New York sits
The same service costs 5.0 times more in Alaska than in Alabama. 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
$74.13
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.