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 $53.70 Median $97.72 Typical High $194.98 | Facility | None | $53.70 | $97.72 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $117.49 | Professional | None | $53.70 | $95.50 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $91.20 | Professional | None | $58.88 | $69.18 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $199.53 | Professional | None | $72.44 | $123.03 | $199.53 |
CDPHP Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $100.00 | Facility | None | $81.28 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $234.42 | Professional | None | $52.48 | $85.11 | $234.42 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $74.13 Typical High $177.83 | Facility | None | $30.20 | $74.13 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $83.18 | Professional | None | $30.90 | $41.69 | $83.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $26.30 Median $69.18 Typical High $93.33 | Professional | None | $26.30 | $69.18 | $93.33 |
Fidelis Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Highmark BCBS Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $194.98 | Professional | None | $74.13 | $97.72 | $194.98 |
MVP Health Care Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $169.82 | Professional | None | $52.48 | $52.48 | $169.82 |
Optum Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $151.36 | Professional | None | $51.29 | $77.62 | $151.36 |
United Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $165.96 | Professional | None | $51.29 | $75.86 | $165.96 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $74.13 Typical High $316.23 | Facility | None | $35.48 | $74.13 | $316.23 |
Univera Setting Professional Modifier None Typical Low $26.30 Median $64.57 Typical High $93.33 | Professional | None | $26.30 | $64.57 | $93.33 |
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 $26.30 Median $26.92 Typical High $30.90 | Professional | 52 · Reduced service | $26.30 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.94 Typical High $9.33 | Professional | 55 · Aftercare only | $7.76 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.37 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.25 | $5.37 | $6.17 |
Where New York sits
The same service costs 2.4 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· 29th of 51
$77.62
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.