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 $128.82 Median $616.60 Typical High $2,041.74 | Facility | None | $128.82 | $616.60 | $2,041.74 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | None | $104.71 | $104.71 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $208.93 | Professional | None | $151.36 | $181.97 | $208.93 |
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 $93.33 Median $165.96 Typical High $2,754.23 | Facility | None | $93.33 | $165.96 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $223.87 | Professional | None | $117.49 | $117.49 | $223.87 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $128.82 Typical High $346.74 | Facility | None | $85.11 | $128.82 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $218.78 | Professional | None | $97.72 | $125.89 | $218.78 |
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 $74.13 Median $100.00 Typical High $128.82 | Professional | None | $74.13 | $100.00 | $128.82 |
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 $100.00 Median $100.00 Typical High $169.82 | Professional | None | $100.00 | $100.00 | $169.82 |
United Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $954.99 | Facility | None | $660.69 | $776.25 | $954.99 |
United Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $151.36 | Professional | None | $75.86 | $104.71 | $151.36 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $125.89 | Facility | None | $15.14 | $15.14 | $125.89 |
Univera Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $128.82 | Professional | None | $74.13 | $97.72 | $128.82 |
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 $52.48 Median $52.48 Typical High $64.57 | Professional | 52 · Reduced service | $52.48 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $20.89 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $109.65 | Professional | 53 · Discontinued | $52.48 | $69.18 | $109.65 |
Where New York sits
The same service costs 3.0 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· 15th 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.