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 $12.30 Median $16.22 Typical High $77.62 | Facility | None | $12.30 | $16.22 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $16.22 | Professional | None | $12.30 | $12.30 | $16.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $10.23 Typical High $11.48 | Professional | None | $8.71 | $10.23 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $22.39 | Professional | None | $8.91 | $8.91 | $22.39 |
Emblem Health Setting Facility Modifier None Typical Low $16.22 Median $26.30 Typical High $61.66 | Facility | None | $16.22 | $26.30 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $21.88 | Professional | None | $17.78 | $17.78 | $21.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.96 Median $13.80 Typical High $19.95 | Professional | None | $10.96 | $13.80 | $19.95 |
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 $13.49 Median $60.26 Typical High $60.26 | Professional | None | $13.49 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $107.15 | Facility | None | $75.86 | $87.10 | $107.15 |
United Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $20.89 | Professional | None | $8.91 | $10.72 | $20.89 |
Univera Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $1,047.13 | Facility | None | $12.88 | $15.49 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $20.42 | Professional | None | $10.96 | $12.88 | $20.42 |
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 $6.17 Median $6.17 Typical High $8.13 | Professional | 52 · Reduced service | $6.17 | $6.17 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $3.24 | Professional | 53 · Discontinued | $2.45 | $2.45 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $2.40 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $1.62 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.91 Typical High $13.18 | Professional | 53 · Discontinued | $6.31 | $8.91 | $13.18 |
Where New York sits
The same service costs 43.7 times more in Hawaii 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
$10.72
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.