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 $60.26 Median $74.13 Typical High $100.00 | Facility | None | $60.26 | $74.13 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $100.00 | Professional | None | $63.10 | $77.62 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $87.10 | Professional | None | $64.57 | $77.62 | $87.10 |
CDPHP Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $63.10 Typical High $128.82 | Professional | None | $58.88 | $63.10 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $398.11 | Facility | None | $53.70 | $89.13 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $81.28 | Professional | None | $57.54 | $66.07 | $81.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $74.13 Typical High $91.20 | Professional | None | $37.15 | $74.13 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $138.04 | Professional | None | $79.43 | $79.43 | $138.04 |
Optum Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $61.66 Median $95.50 Typical High $177.83 | Professional | None | $61.66 | $95.50 | $177.83 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $371.54 | Facility | None | $43.65 | $72.44 | $371.54 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $70.79 Typical High $91.20 | Professional | None | $37.15 | $70.79 | $91.20 |
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 $30.20 Median $31.62 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.76 |
Where New York sits
The same service costs 2.1 times more in Oregon 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· 35th of 51
$75.86
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.