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 $21.88 Median $22.39 Typical High $34.67 | Facility | None | $21.88 | $22.39 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $33.11 | Professional | None | $21.88 | $21.88 | $33.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $22.91 | Facility | None | $21.88 | $21.88 | $22.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
CDPHP Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $21.88 Typical High $85.11 | Facility | None | $19.05 | $21.88 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $104.71 | Professional | None | $21.88 | $21.88 | $104.71 |
Emblem Health Setting Facility Modifier None Typical Low $20.89 Median $27.54 Typical High $46.77 | Facility | None | $20.89 | $27.54 | $46.77 |
Emblem Health Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $24.55 | Professional | None | $20.89 | $20.89 | $24.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $12.02 | Facility | None | $11.48 | $11.48 | $12.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.48 Median $20.42 Typical High $21.88 | Professional | None | $11.48 | $20.42 | $21.88 |
MVP Health Care Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $42.66 | Facility | None | $28.18 | $28.18 | $42.66 |
MVP Health Care Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $22.39 Median $26.30 Typical High $33.88 | Professional | None | $22.39 | $26.30 | $33.88 |
Univera Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $20.42 | Facility | None | $11.48 | $11.48 | $20.42 |
Univera Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $21.88 | Professional | None | $11.48 | $13.80 | $21.88 |
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 $10.96 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.31 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Where New York sits
The same service costs 1.9 times more in Alabama than in Georgia. 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
$20.89
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.