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 $18.62 Median $47.86 Typical High $186.21 | Facility | None | $18.62 | $47.86 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $47.86 Typical High $87.10 | Professional | None | $18.62 | $47.86 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $77.62 | Professional | None | $60.26 | $70.79 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $52.48 Typical High $72.44 | Professional | None | $12.30 | $52.48 | $72.44 |
Emblem Health Setting Facility Modifier None Typical Low $18.62 Median $28.84 Typical High $72.44 | Facility | None | $18.62 | $28.84 | $72.44 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $123.03 | Professional | None | $95.50 | $95.50 | $123.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $64.57 Median $69.18 Typical High $100.00 | Professional | None | $64.57 | $69.18 | $100.00 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $100.00 | Professional | None | $60.26 | $60.26 | $100.00 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $11.75 Median $39.81 Typical High $70.79 | Professional | None | $11.75 | $39.81 | $70.79 |
Univera Setting Facility Modifier None Typical Low $19.95 Median $23.44 Typical High $213.80 | Facility | None | $19.95 | $23.44 | $213.80 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $91.20 | Professional | None | $44.67 | $69.18 | $91.20 |
6 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 $9.33 Median $23.99 Typical High $43.65 | Professional | 52 · Reduced service | $9.33 | $23.99 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $9.55 Typical High $17.38 | Professional | 53 · Discontinued | $3.72 | $9.55 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $7.08 Typical High $13.18 | Professional | 55 · Aftercare only | $2.82 | $7.08 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $4.79 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.86 | $4.79 | $8.71 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $41.69 | $54.95 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where New York sits
The same service costs 4.4 times more in Hawaii than in Washington, DC. 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· 13th of 51
$60.26
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.