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 $20.42 Median $30.20 Typical High $91.20 | Facility | None | $20.42 | $30.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $41.69 | Professional | None | $20.42 | $29.51 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $33.11 Typical High $36.31 | Professional | None | $27.54 | $33.11 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $25.12 Typical High $50.12 | Professional | None | $14.79 | $25.12 | $50.12 |
Emblem Health Setting Facility Modifier None Typical Low $20.89 Median $33.11 Typical High $81.28 | Facility | None | $20.89 | $33.11 | $81.28 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $47.86 Typical High $60.26 | Professional | None | $20.42 | $47.86 | $60.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.95 Median $33.11 Typical High $50.12 | Professional | None | $19.95 | $33.11 | $50.12 |
MVP Health Care Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $52.48 | Professional | None | $30.20 | $30.20 | $52.48 |
United Setting Professional Modifier None Typical Low $14.13 Median $25.70 Typical High $38.90 | Professional | None | $14.13 | $25.70 | $38.90 |
Univera Setting Facility Modifier None Typical Low $21.88 Median $25.70 Typical High $81.28 | Facility | None | $21.88 | $25.70 | $81.28 |
Univera Setting Professional Modifier None Typical Low $20.42 Median $33.11 Typical High $45.71 | Professional | None | $20.42 | $33.11 | $45.71 |
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 $10.23 Median $14.79 Typical High $20.89 | Professional | 52 · Reduced service | $10.23 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $5.89 Typical High $8.32 | Professional | 53 · Discontinued | $4.07 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.37 Typical High $6.31 | Professional | 55 · Aftercare only | $3.09 | $4.37 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.95 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.04 | $2.95 | $4.17 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $28.18 | Professional | 53 · Discontinued | $19.95 | $21.88 | $28.18 |
Where New York sits
The same service costs 2.7 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· 42nd of 51
$30.20
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.