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 $72.44 Median $87.10 Typical High $114.82 | Facility | None | $72.44 | $87.10 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $114.82 | Professional | None | $72.44 | $72.44 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | None | $44.67 | $51.29 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $229.09 | Facility | None | $138.04 | $165.96 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $537.03 | Facility | None | $138.04 | $218.78 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | None | $154.88 | $154.88 | $229.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $169.82 | Professional | None | $120.23 | $125.89 | $169.82 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $169.82 | Professional | None | $120.23 | $125.89 | $169.82 |
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 $36.31 Median $36.31 Typical High $57.54 | Professional | 52 · Reduced service | $36.31 | $36.31 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $22.91 | Professional | 53 · Discontinued | $14.45 | $14.45 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $17.38 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $11.48 |
Where New York sits
The same service costs 26.9 times more in Kansas than in New York. 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· 51st 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.