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 $10.00 Median $12.88 Typical High $77.62 | Facility | None | $10.00 | $12.88 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $38.02 | Professional | None | $10.00 | $10.96 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $33.11 | Professional | None | $14.45 | $17.38 | $33.11 |
CDPHP Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $23.44 Typical High $107.15 | Professional | None | $16.98 | $23.44 | $107.15 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $23.99 Typical High $107.15 | Facility | None | $0.10 | $23.99 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $39.81 Typical High $67.61 | Professional | None | $25.70 | $39.81 | $67.61 |
Excellus BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.95 | Facility | None | $19.50 | $19.50 | $19.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $13.18 Median $19.50 Typical High $22.91 | Professional | None | $13.18 | $19.50 | $22.91 |
Highmark BCBS Setting Facility Modifier None Typical Low $24.55 Median $48.98 Typical High $177.83 | Facility | None | $24.55 | $48.98 | $177.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $48.98 | Professional | None | $47.86 | $48.98 | $48.98 |
MVP Health Care Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
MVP Health Care Setting Professional Modifier None Typical Low $15.85 Median $30.20 Typical High $45.71 | Professional | None | $15.85 | $30.20 | $45.71 |
United Setting Facility Modifier None Typical Low $144.54 Median $169.82 Typical High $208.93 | Facility | None | $144.54 | $169.82 | $208.93 |
United Setting Professional Modifier None Typical Low $11.75 Median $21.38 Typical High $47.86 | Professional | None | $11.75 | $21.38 | $47.86 |
Univera Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $22.91 | Facility | None | $19.50 | $19.50 | $22.91 |
Univera Setting Professional Modifier None Typical Low $13.18 Median $20.89 Typical High $23.44 | Professional | None | $13.18 | $20.89 | $23.44 |
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 $5.01 Median $5.50 Typical High $5.50 | Professional | 52 · Reduced service | $5.01 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.19 Typical High $2.19 | Professional | 53 · Discontinued | $2.00 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.66 Typical High $1.66 | Professional | 55 · Aftercare only | $1.51 | $1.66 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.00 | $1.10 | $1.10 |
Where New York sits
The same service costs 5.4 times more in Vermont than in Kansas. 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
$17.78
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.