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 $100.00 Median $123.03 Typical High $208.93 | Facility | None | $100.00 | $123.03 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $158.49 | Professional | None | $100.00 | $123.03 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $162.18 | Professional | None | $87.10 | $87.10 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $218.78 | Professional | None | $102.33 | $123.03 | $218.78 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $478.63 | Professional | None | $93.33 | $158.49 | $478.63 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $93.33 Typical High $331.13 | Facility | None | $30.20 | $93.33 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $173.78 | Professional | None | $100.00 | $102.33 | $173.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $114.82 | Professional | None | $50.12 | $85.11 | $114.82 |
Highmark BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $316.23 | Professional | None | $138.04 | $138.04 | $316.23 |
Optum Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $275.42 | Professional | None | $100.00 | $158.49 | $275.42 |
United Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $302.00 | Professional | None | $77.62 | $131.83 | $302.00 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $91.20 Typical High $660.69 | Facility | None | $54.95 | $91.20 | $660.69 |
Univera Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $114.82 | Professional | None | $50.12 | $79.43 | $114.82 |
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 $47.86 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $47.86 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $14.45 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.00 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.55 | $10.00 | $11.22 |
Where New York sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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· 38th of 51
$120
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.