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 $123.03 Median $165.96 Typical High $446.68 | Facility | None | $123.03 | $165.96 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Professional | None | $112.20 | $165.96 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $173.78 | Professional | None | $117.49 | $158.49 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | None | $104.71 | $123.03 | $138.04 |
CDPHP Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | None | $213.80 | $213.80 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $1,348.96 | Facility | None | $186.21 | $186.21 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $316.23 | Professional | None | $128.82 | $181.97 | $316.23 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $134.90 Typical High $363.08 | Facility | None | $0.10 | $134.90 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $263.03 | Professional | None | $75.86 | $114.82 | $263.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $323.59 | Professional | None | $112.20 | $112.20 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
Optum Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $199.53 | Professional | None | $138.04 | $177.83 | $199.53 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $229.09 | Professional | None | $104.71 | $144.54 | $229.09 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $181.97 Typical High $794.33 | Facility | None | $75.86 | $181.97 | $794.33 |
Univera Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $194.98 | Professional | None | $75.86 | $112.20 | $194.98 |
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 $56.23 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $56.23 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $20.42 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $20.42 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $13.49 | $18.20 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | HG · Opioid treatment program | $104.71 | $104.71 | $104.71 |
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· 50th of 51
$129
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.