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 $371.54 Median $537.03 Typical High $1,174.90 | Facility | None | $371.54 | $537.03 | $1,174.90 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | None | $371.54 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $616.60 | Professional | None | $323.59 | $380.19 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $870.96 Typical High $870.96 | Facility | None | $512.86 | $870.96 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $831.76 | Professional | None | $363.08 | $426.58 | $831.76 |
Emblem Health Setting Facility Modifier None Typical Low $346.74 Median $575.44 Typical High $1,949.84 | Facility | None | $346.74 | $575.44 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $1,023.29 | Professional | None | $446.68 | $602.56 | $1,023.29 |
Excellus BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $630.96 | Professional | None | $354.81 | $426.58 | $630.96 |
MVP Health Care Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
MVP Health Care Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $602.56 | Professional | None | $338.84 | $338.84 | $602.56 |
United Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $645.65 | Professional | None | $354.81 | $436.52 | $645.65 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $537.03 Typical High $1,479.11 | Facility | None | $213.80 | $537.03 | $1,479.11 |
Univera Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $630.96 | Professional | None | $354.81 | $446.68 | $630.96 |
5 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 $186.21 Median $186.21 Typical High $263.03 | Professional | 52 · Reduced service | $186.21 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $74.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $79.43 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $53.70 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $53.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $436.52 | Professional | 53 · Discontinued | $229.09 | $288.40 | $436.52 |
Where New York sits
The same service costs 3.2 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
$380
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.