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 $114.82 Median $169.82 Typical High $190.55 | Facility | None | $114.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $125.89 | Professional | None | $50.12 | $61.66 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $1,148.15 | Professional | None | $204.17 | $204.17 | $1,148.15 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $251.19 Typical High $467.74 | Facility | None | $173.78 | $251.19 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $588.84 | Professional | None | $208.93 | $398.11 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $380.19 | Professional | None | $186.21 | $229.09 | $380.19 |
MVP Health Care Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $426.58 | Professional | None | $162.18 | $162.18 | $426.58 |
United Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $478.63 | Professional | None | $173.78 | $239.88 | $478.63 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Facility | None | $173.78 | $173.78 | $251.19 |
Univera Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $380.19 | Professional | None | $186.21 | $229.09 | $380.19 |
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 $57.54 Median $57.54 Typical High $85.11 | Professional | 52 · Reduced service | $57.54 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $33.88 | Professional | 53 · Discontinued | $22.91 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $16.98 |
Where New York sits
The same service costs 26.9 times more in Alaska than in Virginia. 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
$64.57
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.