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 $25.70 Typical High $50.12 | Facility | None | $21.88 | $25.70 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $22.91 Typical High $48.98 | Professional | None | $20.42 | $22.91 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $20.42 Typical High $25.12 | Professional | None | $17.38 | $20.42 | $25.12 |
CDPHP Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $114.82 Typical High $251.19 | Facility | None | $30.90 | $114.82 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $18.62 Typical High $58.88 | Professional | None | $16.22 | $18.62 | $58.88 |
Emblem Health Setting Facility Modifier None Typical Low $15.14 Median $21.38 Typical High $69.18 | Facility | None | $15.14 | $21.38 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $45.71 | Professional | None | $20.89 | $22.91 | $45.71 |
Excellus BCBS Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.79 Median $19.05 Typical High $44.67 | Professional | None | $14.79 | $19.05 | $44.67 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $46.77 | Professional | None | $19.05 | $19.05 | $46.77 |
United Setting Facility Modifier None Typical Low $436.52 Median $501.19 Typical High $616.60 | Facility | None | $436.52 | $501.19 | $616.60 |
United Setting Professional Modifier None Typical Low $14.45 Median $21.88 Typical High $56.23 | Professional | None | $14.45 | $21.88 | $56.23 |
Univera Setting Facility Modifier None Typical Low $20.42 Median $45.71 Typical High $67.61 | Facility | None | $20.42 | $45.71 | $67.61 |
Univera Setting Professional Modifier None Typical Low $14.79 Median $22.39 Typical High $44.67 | Professional | None | $14.79 | $22.39 | $44.67 |
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 $9.33 Median $9.33 Typical High $11.75 | Professional | 52 · Reduced service | $9.33 | $9.33 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $4.68 | Professional | 53 · Discontinued | $3.80 | $3.80 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.55 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $2.34 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.45 Typical High $28.18 | Professional | 53 · Discontinued | $11.22 | $14.45 | $28.18 |
Where New York sits
The same service costs 2.8 times more in Alaska than in Florida. 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· 48th of 51
$20.42
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.