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 $87.10 Median $114.82 Typical High $288.40 | Facility | None | $87.10 | $114.82 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $134.90 | Professional | None | $87.10 | $114.82 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $114.82 | Professional | None | $87.10 | $102.33 | $114.82 |
CDPHP Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | None | $138.04 | $138.04 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $158.49 | Professional | None | $56.23 | $77.62 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $18.20 Median $81.28 Typical High $288.40 | Facility | None | $18.20 | $81.28 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $169.82 | Professional | None | $109.65 | $141.25 | $169.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $154.88 | Professional | None | $85.11 | $100.00 | $154.88 |
Highmark BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $234.42 | Professional | None | $120.23 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $123.03 | Professional | None | $52.48 | $81.28 | $123.03 |
Univera Setting Facility Modifier None Typical Low $89.13 Median $104.71 Typical High $213.80 | Facility | None | $89.13 | $104.71 | $213.80 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $141.25 | Professional | None | $85.11 | $109.65 | $141.25 |
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 $43.65 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $43.65 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $17.38 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $13.18 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.71 | $11.48 | $13.49 |
Where New York sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 47th of 51
$97.72
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.