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 $141.25 Median $199.53 Typical High $467.74 | Facility | None | $141.25 | $199.53 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $204.17 Typical High $269.15 | Professional | None | $141.25 | $204.17 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $218.78 | Professional | None | $147.91 | $204.17 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $173.78 | Professional | None | $128.82 | $154.88 | $173.78 |
CDPHP Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | None | $263.03 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $389.05 | Professional | None | $147.91 | $229.09 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $151.36 Typical High $457.09 | Facility | None | $0.10 | $151.36 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $316.23 | Professional | None | $95.50 | $147.91 | $316.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $398.11 | Professional | None | $138.04 | $138.04 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
MVP Health Care Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Optum Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $251.19 | Professional | None | $162.18 | $234.42 | $251.19 |
United Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $275.42 | Professional | None | $134.90 | $181.97 | $275.42 |
Univera Setting Facility Modifier None Typical Low $93.33 Median $223.87 Typical High $1,071.52 | Facility | None | $93.33 | $223.87 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $234.42 | Professional | None | $95.50 | $138.04 | $234.42 |
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 $69.18 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $69.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.60 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.13 | $16.60 | $22.39 |
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 2.4 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· 49th of 51
$166
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.