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 $79.43 Median $95.50 Typical High $208.93 | Facility | None | $79.43 | $95.50 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | None | $79.43 | $79.43 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $114.82 | Professional | None | $66.07 | $77.62 | $114.82 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $128.82 | Facility | None | $104.71 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $169.82 | Professional | None | $63.10 | $74.13 | $169.82 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $234.42 Typical High $457.09 | Facility | None | $89.13 | $234.42 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $147.91 | Professional | None | $89.13 | $89.13 | $147.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $109.65 | Professional | None | $61.66 | $74.13 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $323.59 | Professional | None | $213.80 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $128.82 | Professional | None | $54.95 | $87.10 | $128.82 |
Univera Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $870.96 | Facility | None | $72.44 | $95.50 | $870.96 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $102.33 | Professional | None | $60.26 | $74.13 | $102.33 |
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 $39.81 Median $39.81 Typical High $46.77 | Professional | 52 · Reduced service | $39.81 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $18.62 | Professional | 53 · Discontinued | $15.85 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $9.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $58.88 Typical High $77.62 | Professional | 53 · Discontinued | $46.77 | $58.88 | $77.62 |
Where New York sits
The same service costs 3.1 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
$79.43
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.