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 $38.90 Median $43.65 Typical High $79.43 | Facility | None | $38.90 | $43.65 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $57.54 | Professional | None | $38.90 | $38.90 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $58.88 Typical High $87.10 | Professional | None | $47.86 | $58.88 | $87.10 |
CDPHP Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $181.97 | Professional | None | $38.90 | $64.57 | $181.97 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $131.83 | Facility | None | $34.67 | $54.95 | $131.83 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $77.62 | Professional | None | $45.71 | $45.71 | $77.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $44.67 | Professional | None | $30.20 | $36.31 | $44.67 |
MVP Health Care Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $128.82 | Professional | None | $37.15 | $37.15 | $128.82 |
Optum Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $26.92 Median $47.86 Typical High $120.23 | Professional | None | $26.92 | $47.86 | $120.23 |
Univera Setting Facility Modifier None Typical Low $20.42 Median $33.88 Typical High $239.88 | Facility | None | $20.42 | $33.88 | $239.88 |
Univera Setting Professional Modifier None Typical Low $21.38 Median $36.31 Typical High $44.67 | Professional | None | $21.38 | $36.31 | $44.67 |
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 $19.50 Median $19.50 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $6.76 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $4.47 |
Where New York sits
The same service costs 2.6 times more in Nebraska than in Texas. 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· 25th of 51
$53.70
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.