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 $53.70 Median $588.84 Typical High $2,041.74 | Facility | None | $53.70 | $588.84 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $114.82 Typical High $144.54 | Professional | None | $44.67 | $114.82 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $234.42 | Professional | None | $169.82 | $204.17 | $234.42 |
CDPHP Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $186.21 | Professional | None | $63.10 | $63.10 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $158.49 Typical High $3,467.37 | Facility | None | $63.10 | $158.49 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $134.90 Typical High $181.97 | Professional | None | $45.71 | $134.90 | $181.97 |
Emblem Health Setting Facility Modifier None Typical Low $42.66 Median $95.50 Typical High $181.97 | Facility | None | $42.66 | $95.50 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $269.15 | Professional | None | $120.23 | $158.49 | $269.15 |
Excellus BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $199.53 | Professional | None | $89.13 | $125.89 | $199.53 |
MVP Health Care Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
MVP Health Care Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $204.17 | Professional | None | $89.13 | $89.13 | $204.17 |
United Setting Facility Modifier None Typical Low $426.58 Median $501.19 Typical High $616.60 | Facility | None | $426.58 | $501.19 | $616.60 |
United Setting Professional Modifier None Typical Low $33.88 Median $89.13 Typical High $165.96 | Professional | None | $33.88 | $89.13 | $165.96 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $158.49 | Facility | None | $15.14 | $15.14 | $158.49 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $199.53 | Professional | None | $89.13 | $120.23 | $199.53 |
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 $22.39 Median $57.54 Typical High $63.10 | Professional | 52 · Reduced service | $22.39 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $22.91 Typical High $25.12 | Professional | 53 · Discontinued | $8.91 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $6.76 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.47 | $11.48 | $12.59 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $85.11 | $131.83 |
Where New York sits
The same service costs 3.5 times more in Wisconsin than in Washington, DC. 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· 6th of 51
$158
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.