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 $83.18 Median $100.00 Typical High $338.84 | Facility | None | $83.18 | $100.00 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $123.03 | Professional | None | $83.18 | $91.20 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $177.83 | Professional | None | $97.72 | $107.15 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $158.49 | Professional | None | $93.33 | $109.65 | $158.49 |
CDPHP Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | None | $154.88 | $154.88 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $3,715.35 Typical High $5,248.07 | Facility | None | $1,698.24 | $3,715.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $213.80 | Professional | None | $85.11 | $95.50 | $213.80 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $114.82 Typical High $380.19 | Facility | None | $64.57 | $114.82 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $269.15 | Professional | None | $158.49 | $158.49 | $269.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $162.18 | Professional | None | $57.54 | $123.03 | $162.18 |
Highmark BCBS Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $288.40 | Professional | None | $151.36 | $181.97 | $288.40 |
MVP Health Care Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $199.53 | Professional | None | $89.13 | $89.13 | $199.53 |
United Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $158.49 | Professional | None | $77.62 | $100.00 | $158.49 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $537.03 | Facility | None | $60.26 | $100.00 | $537.03 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $162.18 | Professional | None | $89.13 | $114.82 | $162.18 |
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 $41.69 Median $44.67 Typical High $46.77 | Professional | 52 · Reduced service | $41.69 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.49 Typical High $13.80 | Professional | 55 · Aftercare only | $12.59 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $9.33 |
Where New York sits
The same service costs 2.7 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· 48th of 51
$102
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.