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 $15.49 Median $20.89 Typical High $41.69 | Facility | None | $15.49 | $20.89 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | None | $15.49 | $15.49 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $22.91 | Professional | None | $13.49 | $15.85 | $22.91 |
CDPHP Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $21.88 Median $30.90 Typical High $30.90 | Facility | None | $21.88 | $30.90 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $14.79 Typical High $33.88 | Professional | None | $12.88 | $14.79 | $33.88 |
Emblem Health Setting Facility Modifier None Typical Low $10.00 Median $20.89 Typical High $69.18 | Facility | None | $10.00 | $20.89 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $15.49 Median $21.38 Typical High $36.31 | Professional | None | $15.49 | $21.38 | $36.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $21.88 | Professional | None | $12.30 | $15.49 | $21.88 |
MVP Health Care Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
MVP Health Care Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $23.99 | Professional | None | $21.38 | $21.38 | $23.99 |
United Setting Professional Modifier None Typical Low $13.18 Median $17.38 Typical High $25.70 | Professional | None | $13.18 | $17.38 | $25.70 |
Univera Setting Facility Modifier None Typical Low $14.45 Median $19.05 Typical High $66.07 | Facility | None | $14.45 | $19.05 | $66.07 |
Univera Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $21.88 | Professional | None | $12.30 | $15.49 | $21.88 |
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 $7.76 Median $7.76 Typical High $9.33 | Professional | 52 · Reduced service | $7.76 | $7.76 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.09 Typical High $3.72 | Professional | 53 · Discontinued | $3.09 | $3.09 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.29 Typical High $2.82 | Professional | 55 · Aftercare only | $2.29 | $2.29 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.55 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.55 | $1.55 | $1.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.75 Typical High $15.49 | Professional | 53 · Discontinued | $9.33 | $11.75 | $15.49 |
Where New York sits
The same service costs 3.4 times more in Alaska than in Florida. 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
$15.85
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.