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 $29.51 Median $97.72 Typical High $194.98 | Facility | None | $29.51 | $97.72 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $87.10 Typical High $114.82 | Professional | None | $29.51 | $87.10 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $83.18 | Professional | None | $37.15 | $43.65 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $114.82 | Professional | None | $38.90 | $67.61 | $114.82 |
CDPHP Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $141.25 | Facility | None | $61.66 | $61.66 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $47.86 Typical High $128.82 | Professional | None | $28.84 | $47.86 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $50.12 Typical High $165.96 | Facility | None | $30.20 | $50.12 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $51.29 | Professional | None | $30.20 | $30.90 | $51.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $14.45 Median $42.66 Typical High $57.54 | Professional | None | $14.45 | $42.66 | $57.54 |
Fidelis Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $39.81 Median $50.12 Typical High $120.23 | Professional | None | $39.81 | $50.12 | $120.23 |
MVP Health Care Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
MVP Health Care Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $93.33 | Professional | None | $44.67 | $44.67 | $93.33 |
Optum Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $79.43 | Professional | None | $36.31 | $43.65 | $79.43 |
United Setting Professional Modifier None Typical Low $30.20 Median $40.74 Typical High $93.33 | Professional | None | $30.20 | $40.74 | $93.33 |
Univera Setting Facility Modifier None Typical Low $19.50 Median $45.71 Typical High $213.80 | Facility | None | $19.50 | $45.71 | $213.80 |
Univera Setting Professional Modifier None Typical Low $14.45 Median $39.81 Typical High $57.54 | Professional | None | $14.45 | $39.81 | $57.54 |
3 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 $14.13 Median $14.79 Typical High $16.98 | Professional | 52 · Reduced service | $14.13 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.47 Typical High $5.13 | Professional | 55 · Aftercare only | $4.27 | $4.47 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.95 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.82 | $2.95 | $3.31 |
Where New York sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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
$46.77
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.