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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $9.33 | Professional | None | $6.92 | $6.92 | $9.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.76 Median $9.12 Typical High $10.23 | Professional | None | $7.76 | $9.12 | $10.23 |
CDPHP Setting Professional Modifier None Typical Low $2.04 Median $10.23 Typical High $11.22 | Professional | None | $2.04 | $10.23 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $74.13 Typical High $177.83 | Facility | None | $11.48 | $74.13 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $21.88 | Professional | None | $7.76 | $7.76 | $21.88 |
Emblem Health Setting Facility Modifier None Typical Low $5.37 Median $7.94 Typical High $25.70 | Facility | None | $5.37 | $7.94 | $25.70 |
Emblem Health Setting Professional Modifier None Typical Low $9.33 Median $9.55 Typical High $14.45 | Professional | None | $9.33 | $9.55 | $14.45 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.46 Median $7.76 Typical High $10.23 | Professional | None | $6.46 | $7.76 | $10.23 |
MVP Health Care Setting Professional Modifier None Typical Low $15.49 Median $32.36 Typical High $32.36 | Professional | None | $15.49 | $32.36 | $32.36 |
United Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $371.54 | Facility | None | $257.04 | $302.00 | $371.54 |
United Setting Professional Modifier None Typical Low $5.25 Median $7.76 Typical High $13.80 | Professional | None | $5.25 | $7.76 | $13.80 |
Univera Setting Facility Modifier None Typical Low $7.59 Median $10.23 Typical High $120.23 | Facility | None | $7.59 | $10.23 | $120.23 |
Univera Setting Professional Modifier None Typical Low $4.37 Median $7.76 Typical High $10.23 | Professional | None | $4.37 | $7.76 | $10.23 |
6 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 $3.47 Median $3.47 Typical High $4.37 | Professional | 52 · Reduced service | $3.47 | $3.47 | $4.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.38 Median $1.38 Typical High $1.74 | Professional | 53 · Discontinued | $1.38 | $1.38 | $1.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $5.25 Median $5.25 Typical High $6.46 | Professional | 54 · Surgery only | $5.25 | $5.25 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.05 Typical High $1.29 | Professional | 55 · Aftercare only | $1.05 | $1.05 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $0.85 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $5.01 Typical High $6.31 | Professional | 53 · Discontinued | $4.17 | $5.01 | $6.31 |
Where New York sits
The same service costs 2.3 times more in Hawaii than in North Carolina. 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· 42nd of 51
$8.71
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.