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 $77.62 Median $107.15 Typical High $223.87 | Facility | None | $77.62 | $107.15 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $141.25 | Professional | None | $77.62 | $104.71 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $199.53 | Professional | None | $89.13 | $104.71 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $288.40 | Professional | None | $104.71 | $177.83 | $288.40 |
CDPHP Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $169.82 | Facility | None | $151.36 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $338.84 | Professional | None | $75.86 | $123.03 | $338.84 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $114.82 Typical High $398.11 | Facility | None | $30.20 | $114.82 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $125.89 | Professional | None | $30.90 | $52.48 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $104.71 Typical High $138.04 | Professional | None | $37.15 | $104.71 | $138.04 |
Fidelis Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $85.11 | Professional | None | $74.13 | $74.13 | $85.11 |
Highmark BCBS Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $295.12 | Professional | None | $109.65 | $134.90 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
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 $70.79 Median $112.20 Typical High $213.80 | Professional | None | $70.79 | $112.20 | $213.80 |
United Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $239.88 | Professional | None | $72.44 | $107.15 | $239.88 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $109.65 Typical High $436.52 | Facility | None | $51.29 | $109.65 | $436.52 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $95.50 Typical High $138.04 | Professional | None | $37.15 | $95.50 | $138.04 |
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 $37.15 Median $38.90 Typical High $44.67 | Professional | 52 · Reduced service | $37.15 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.59 | $7.76 | $8.91 |
Where New York sits
The same service costs 2.5 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· 41st of 51
$105
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.