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 $69.18 Typical High $141.25 | Facility | None | $20.42 | $69.18 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $61.66 Typical High $81.28 | Professional | None | $20.42 | $61.66 | $81.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $79.43 | Professional | None | $60.26 | $70.79 | $79.43 |
CDPHP Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $123.03 | Professional | None | $35.48 | $35.48 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $56.23 Typical High $134.90 | Professional | None | $18.20 | $56.23 | $134.90 |
Emblem Health Setting Facility Modifier None Typical Low $14.79 Median $23.44 Typical High $77.62 | Facility | None | $14.79 | $23.44 | $77.62 |
Emblem Health Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $125.89 | Professional | None | $72.44 | $75.86 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $74.13 | Professional | None | $39.81 | $60.26 | $74.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
MVP Health Care Setting Professional Modifier None Typical Low $97.72 Median $251.19 Typical High $251.19 | Professional | None | $97.72 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $19.05 Median $51.29 Typical High $123.03 | Professional | None | $19.05 | $51.29 | $123.03 |
Univera Setting Facility Modifier None Typical Low $16.22 Median $25.70 Typical High $37.15 | Facility | None | $16.22 | $25.70 | $37.15 |
Univera Setting Professional Modifier None Typical Low $39.81 Median $60.26 Typical High $74.13 | Professional | None | $39.81 | $60.26 | $74.13 |
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 $10.23 Median $30.90 Typical High $36.31 | Professional | 52 · Reduced service | $10.23 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $12.30 Typical High $14.45 | Professional | 53 · Discontinued | $4.07 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $9.12 Typical High $10.96 | Professional | 55 · Aftercare only | $3.09 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $6.17 Typical High $7.24 | Professional | 56 · Pre-op care only | $2.04 | $6.17 | $7.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $67.61 | Professional | 53 · Discontinued | $38.02 | $48.98 | $67.61 |
Where New York sits
The same service costs 4.4 times more in North Dakota than in Kentucky. 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· 18th of 51
$67.61
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.