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 $72.44 Median $125.89 Typical High $208.93 | Facility | None | $72.44 | $125.89 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $151.36 | Professional | None | $75.86 | $125.89 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $138.04 | Professional | None | $61.66 | $72.44 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $275.42 | Professional | None | $95.50 | $158.49 | $275.42 |
CDPHP Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $104.71 | Facility | None | $91.20 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $331.13 | Professional | None | $74.13 | $120.23 | $331.13 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $281.84 | Facility | None | $60.26 | $89.13 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $87.10 | Professional | None | $30.90 | $69.18 | $87.10 |
Excellus BCBS Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $95.50 | Professional | None | $34.67 | $72.44 | $95.50 |
Highmark BCBS Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $213.80 | Professional | None | $85.11 | $141.25 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $245.47 | Professional | None | $70.79 | $70.79 | $245.47 |
Optum Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $218.78 | Professional | None | $50.12 | $79.43 | $218.78 |
United Setting Professional Modifier None Typical Low $60.26 Median $102.33 Typical High $229.09 | Professional | None | $60.26 | $102.33 | $229.09 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $77.62 Typical High $407.38 | Facility | None | $45.71 | $77.62 | $407.38 |
Univera Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $95.50 | Professional | None | $34.67 | $67.61 | $95.50 |
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 $36.31 Median $38.02 Typical High $40.74 | Professional | 52 · Reduced service | $36.31 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $12.30 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $8.13 |
Fidelis Setting Professional Modifier AI · Physician of record Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | AI · Physician of record | $72.44 | $72.44 | $72.44 |
Where New York sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 36th of 51
$97.72
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.