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 $21.88 Median $31.62 Typical High $63.10 | Facility | None | $21.88 | $31.62 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $31.62 | Professional | None | $21.88 | $21.88 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $28.18 Typical High $32.36 | Professional | None | $23.99 | $28.18 | $32.36 |
CDPHP Setting Professional Modifier None Typical Low $11.48 Median $30.20 Typical High $38.90 | Professional | None | $11.48 | $30.20 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $41.69 Typical High $53.70 | Facility | None | $33.88 | $41.69 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $75.86 | Professional | None | $28.84 | $29.51 | $75.86 |
Emblem Health Setting Facility Modifier None Typical Low $21.88 Median $33.11 Typical High $107.15 | Facility | None | $21.88 | $33.11 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $48.98 | Professional | None | $32.36 | $32.36 | $48.98 |
Excellus BCBS Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Facility | None | $10.00 | $10.00 | $10.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $33.88 | Professional | None | $21.88 | $25.70 | $33.88 |
MVP Health Care Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
MVP Health Care Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $44.67 | Professional | None | $29.51 | $29.51 | $44.67 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $20.42 Median $27.54 Typical High $50.12 | Professional | None | $20.42 | $27.54 | $50.12 |
Univera Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $100.00 | Facility | None | $10.00 | $10.00 | $100.00 |
Univera Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $33.88 | Professional | None | $21.88 | $25.70 | $33.88 |
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 $10.96 Median $10.96 Typical High $14.13 | Professional | 52 · Reduced service | $10.96 | $10.96 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $5.62 | Professional | 53 · Discontinued | $4.37 | $4.37 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.24 Typical High $4.27 | Professional | 55 · Aftercare only | $3.24 | $3.24 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $12.88 | $16.60 | $20.42 |
Where New York sits
The same service costs 2.5 times more in Minnesota than in Arkansas. 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
$28.84
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.