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 $50.12 Median $66.07 Typical High $162.18 | Facility | None | $50.12 | $66.07 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $53.70 | Professional | None | $38.90 | $45.71 | $53.70 |
CDPHP Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $169.82 | Professional | None | $50.12 | $67.61 | $169.82 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $87.10 Typical High $288.40 | Facility | None | $57.54 | $87.10 | $288.40 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $158.49 | Professional | None | $87.10 | $114.82 | $158.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $85.11 | Professional | None | $30.20 | $56.23 | $85.11 |
MVP Health Care Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $120.23 | Professional | None | $48.98 | $48.98 | $120.23 |
United Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $147.91 | Professional | None | $54.95 | $69.18 | $147.91 |
Univera Setting Facility Modifier None Typical Low $66.07 Median $69.18 Typical High $89.13 | Facility | None | $66.07 | $69.18 | $89.13 |
Univera Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $85.11 | Professional | None | $30.20 | $56.23 | $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 $24.55 Median $24.55 Typical High $34.67 | Professional | 52 · Reduced service | $24.55 | $24.55 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $13.80 | Professional | 53 · Discontinued | $10.00 | $10.00 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $10.47 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $6.92 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 50th of 51
$47.86
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.