How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $15.85 Median $19.05 Typical High $23.44 | Facility | None | $15.85 | $19.05 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $23.44 | Professional | None | $15.85 | $15.85 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.88 Median $15.49 Typical High $22.39 | Professional | None | $12.88 | $15.49 | $22.39 |
CDPHP Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $31.62 Typical High $104.71 | Professional | None | $12.02 | $31.62 | $104.71 |
Emblem Health Setting Facility Modifier None Typical Low $38.90 Median $48.98 Typical High $67.61 | Facility | None | $38.90 | $48.98 | $67.61 |
Emblem Health Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $61.66 | Professional | None | $32.36 | $38.90 | $61.66 |
Excellus BCBS Setting Professional Modifier None Typical Low $11.48 Median $18.62 Typical High $28.84 | Professional | None | $11.48 | $18.62 | $28.84 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $16.98 Median $23.99 Typical High $47.86 | Professional | None | $16.98 | $23.99 | $47.86 |
Univera Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $144.54 | Facility | None | $22.39 | $23.44 | $144.54 |
Univera Setting Professional Modifier None Typical Low $13.49 Median $23.44 Typical High $144.54 | Professional | None | $13.49 | $23.44 | $144.54 |
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 $7.94 Median $7.94 Typical High $11.75 | Professional | 52 · Reduced service | $7.94 | $7.94 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $4.68 | Professional | 53 · Discontinued | $3.24 | $3.24 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $3.55 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.58 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.58 | $1.58 | $2.34 |
Where New York sits
The same service costs 4.3 times more in Alaska than in New York. 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· 51st of 51
$16.22
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.