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 $20.42 Median $3,467.37 Typical High $7,762.47 | Facility | None | $20.42 | $3,467.37 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $20.42 Typical High $7,244.36 | Professional | None | $18.20 | $20.42 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $12.59 Median $15.14 Typical High $28.84 | Professional | None | $12.59 | $15.14 | $28.84 |
CDPHP Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $123.03 | Facility | None | $30.90 | $30.90 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $27.54 Typical High $91.20 | Professional | None | $14.13 | $27.54 | $91.20 |
Emblem Health Setting Facility Modifier None Typical Low $20.42 Median $33.11 Typical High $79.43 | Facility | None | $20.42 | $33.11 | $79.43 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $57.54 | Professional | None | $22.39 | $34.67 | $57.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $28.84 | Professional | None | $15.49 | $18.20 | $28.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $51.29 Median $61.66 Typical High $89.13 | Facility | None | $51.29 | $61.66 | $89.13 |
MVP Health Care Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $47.86 | Professional | None | $18.20 | $30.90 | $47.86 |
United Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $134.90 | Facility | None | $93.33 | $109.65 | $134.90 |
United Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $47.86 | Professional | None | $17.38 | $22.91 | $47.86 |
Univera Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $19.50 | Facility | None | $18.20 | $18.20 | $19.50 |
Univera Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $42.66 | Professional | None | $15.49 | $18.20 | $42.66 |
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 $9.12 Median $9.12 Typical High $11.22 | Professional | 52 · Reduced service | $9.12 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $3.31 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.24 |
Where New York sits
The same service costs 40.7 times more in Tennessee 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
$16.60
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.