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 $40.74 Median $56.23 Typical High $302.00 | Facility | None | $40.74 | $56.23 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $141.25 Typical High $302.00 | Professional | None | $40.74 | $141.25 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $70.79 Typical High $89.13 | Professional | None | $51.29 | $70.79 | $89.13 |
CDPHP Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $97.72 | Professional | None | $79.43 | $79.43 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $64.57 Typical High $147.91 | Professional | None | $43.65 | $64.57 | $147.91 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $190.55 | Facility | None | $50.12 | $79.43 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $147.91 | Professional | None | $83.18 | $107.15 | $147.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $74.13 | Professional | None | $31.62 | $41.69 | $74.13 |
MVP Health Care Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $123.03 | Professional | None | $58.88 | $58.88 | $123.03 |
United Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $134.90 | Professional | None | $41.69 | $63.10 | $134.90 |
Univera Setting Facility Modifier None Typical Low $30.20 Median $69.18 Typical High $79.43 | Facility | None | $30.20 | $69.18 | $79.43 |
Univera Setting Professional Modifier None Typical Low $31.62 Median $41.69 Typical High $74.13 | Professional | None | $31.62 | $41.69 | $74.13 |
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 $20.42 Median $102.33 Typical High $151.36 | Professional | 52 · Reduced service | $20.42 | $102.33 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $34.67 Typical High $44.67 | Professional | 55 · Aftercare only | $6.17 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $22.91 Typical High $30.20 | Professional | 56 · Pre-op care only | $4.07 | $22.91 | $30.20 |
Where New York sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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· 13th of 51
$70.79
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.