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 $10.72 Median $11.75 Typical High $27.54 | Facility | None | $10.72 | $11.75 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $13.80 | Professional | None | $10.72 | $10.72 | $13.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.12 Median $10.72 Typical High $12.02 | Professional | None | $9.12 | $10.72 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $19.50 | Professional | None | $7.59 | $7.59 | $19.50 |
Emblem Health Setting Facility Modifier None Typical Low $13.80 Median $22.91 Typical High $53.70 | Facility | None | $13.80 | $22.91 | $53.70 |
Emblem Health Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $19.95 | Professional | None | $15.49 | $15.49 | $19.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $9.33 Median $10.23 Typical High $14.79 | Professional | None | $9.33 | $10.23 | $14.79 |
MVP Health Care Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $14.45 | Professional | None | $10.72 | $10.72 | $14.45 |
United Setting Facility Modifier None Typical Low $117.49 Median $138.04 Typical High $169.82 | Facility | None | $117.49 | $138.04 | $169.82 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.12 Typical High $15.85 | Professional | None | $7.59 | $9.12 | $15.85 |
Univera Setting Facility Modifier None Typical Low $11.22 Median $13.18 Typical High $74.13 | Facility | None | $11.22 | $13.18 | $74.13 |
Univera Setting Professional Modifier None Typical Low $7.08 Median $10.23 Typical High $13.18 | Professional | None | $7.08 | $10.23 | $13.18 |
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 $5.37 Median $5.37 Typical High $6.76 | Professional | 52 · Reduced service | $5.37 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.14 Median $2.14 Typical High $2.75 | Professional | 53 · Discontinued | $2.14 | $2.14 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.58 Typical High $2.04 | Professional | 55 · Aftercare only | $1.58 | $1.58 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $1.07 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.07 | $1.07 | $1.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $7.76 Typical High $11.22 | Professional | 53 · Discontinued | $5.37 | $7.76 | $11.22 |
Where New York sits
The same service costs 3.2 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· 46th 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.