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 $102.33 Median $117.49 Typical High $251.19 | Facility | None | $102.33 | $117.49 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | None | $102.33 | $102.33 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $125.89 | Professional | None | $93.33 | $109.65 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $676.08 | Facility | None | $177.83 | $177.83 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $295.12 | Professional | None | $81.28 | $100.00 | $295.12 |
Emblem Health Setting Facility Modifier None Typical Low $112.20 Median $181.97 Typical High $436.52 | Facility | None | $112.20 | $181.97 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $194.98 | Professional | None | $125.89 | $128.82 | $194.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $134.90 | Professional | None | $85.11 | $102.33 | $134.90 |
MVP Health Care Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $263.03 | Professional | None | $83.18 | $83.18 | $263.03 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $295.12 | Professional | None | $85.11 | $114.82 | $295.12 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $114.82 Typical High $446.68 | Facility | None | $100.00 | $114.82 | $446.68 |
Univera Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $134.90 | Professional | None | $72.44 | $102.33 | $134.90 |
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 $50.12 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $50.12 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $12.30 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $141.25 | Professional | 53 · Discontinued | $57.54 | $74.13 | $141.25 |
Where New York sits
The same service costs 2.8 times more in Alaska than in Texas. 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
$107
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.