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 $109.65 Median $147.91 Typical High $288.40 | Facility | None | $109.65 | $147.91 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $147.91 | Professional | None | $109.65 | $109.65 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $134.90 | Professional | None | $95.50 | $117.49 | $134.90 |
CDPHP Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $218.78 | Facility | None | $125.89 | $204.17 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $269.15 | Professional | None | $112.20 | $131.83 | $269.15 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $131.83 Typical High $457.09 | Facility | None | $64.57 | $131.83 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $208.93 | Professional | None | $144.54 | $144.54 | $208.93 |
Excellus BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $141.25 | Professional | None | $87.10 | $120.23 | $141.25 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | None | $141.25 | $141.25 | $165.96 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $158.49 | Facility | None | $123.03 | $123.03 | $158.49 |
United Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $181.97 | Professional | None | $95.50 | $128.82 | $181.97 |
Univera Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $478.63 | Facility | None | $102.33 | $134.90 | $478.63 |
Univera Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $134.90 | Professional | None | $87.10 | $120.23 | $134.90 |
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 $54.95 Median $54.95 Typical High $74.13 | Professional | 52 · Reduced service | $54.95 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $29.51 | Professional | 53 · Discontinued | $21.88 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $14.79 |
Where New York sits
The same service costs 2.8 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· 43rd of 51
$120
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.