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 $79.43 Median $97.72 Typical High $194.98 | Facility | None | $79.43 | $97.72 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $128.82 | Professional | None | $79.43 | $79.43 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $95.50 | Professional | None | $70.79 | $83.18 | $95.50 |
CDPHP Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $190.55 | Professional | None | $61.66 | $100.00 | $190.55 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $309.03 | Facility | None | $57.54 | $93.33 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $162.18 | Professional | None | $93.33 | $100.00 | $162.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $102.33 | Professional | None | $56.23 | $74.13 | $102.33 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $123.03 | Professional | None | $60.26 | $60.26 | $123.03 |
United Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $194.98 | Professional | None | $66.07 | $89.13 | $194.98 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $89.13 Typical High $128.82 | Facility | None | $56.23 | $89.13 | $128.82 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $102.33 | Professional | None | $56.23 | $74.13 | $102.33 |
6 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 $39.81 Median $39.81 Typical High $48.98 | Professional | 52 · Reduced service | $39.81 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | 53 · Discontinued | $16.22 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $14.45 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $9.77 |
Highmark BCBS Setting Facility Modifier XP · Separate practitioner Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | XP · Separate practitioner | $407.38 | $407.38 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $91.20 | Professional | 53 · Discontinued | $44.67 | $56.23 | $91.20 |
Where New York sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 48th of 51
$83.18
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.