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 $61.66 Median $74.13 Typical High $181.97 | Facility | None | $61.66 | $74.13 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $85.11 | Professional | None | $61.66 | $70.79 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $81.28 | Professional | None | $58.88 | $70.79 | $81.28 |
CDPHP Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $154.88 | Professional | None | $75.86 | $89.13 | $154.88 |
Emblem Health Setting Facility Modifier None Typical Low $61.66 Median $97.72 Typical High $239.88 | Facility | None | $61.66 | $97.72 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $141.25 | Professional | None | $93.33 | $93.33 | $141.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $87.10 | Professional | None | $54.95 | $77.62 | $87.10 |
MVP Health Care Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $104.71 | Professional | None | $70.79 | $70.79 | $104.71 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $75.86 | Facility | None | $58.88 | $58.88 | $75.86 |
United Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $131.83 | Professional | None | $51.29 | $74.13 | $131.83 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $72.44 Typical High $199.53 | Facility | None | $56.23 | $72.44 | $199.53 |
Univera Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $85.11 | Professional | None | $43.65 | $77.62 | $85.11 |
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 $30.20 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $30.20 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $17.38 | Professional | 53 · Discontinued | $12.30 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.08 Typical High $8.51 | Professional | 56 · Pre-op care only | $6.17 | $7.08 | $8.51 |
Where New York sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 45th of 51
$70.79
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.