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 $125.89 Median $204.17 Typical High $213.80 | Facility | None | $125.89 | $204.17 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $213.80 | Professional | None | $125.89 | $125.89 | $213.80 |
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 $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $1,445.44 | Professional | None | $257.04 | $257.04 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $524.81 | Facility | None | $190.55 | $281.84 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $446.68 Typical High $660.69 | Professional | None | $234.42 | $446.68 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $467.74 | Professional | None | $199.53 | $281.84 | $467.74 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $478.63 | Professional | None | $177.83 | $177.83 | $478.63 |
United Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $524.81 | Professional | None | $213.80 | $288.40 | $524.81 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $316.23 | Facility | None | $190.55 | $190.55 | $316.23 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $467.74 | Professional | None | $199.53 | $281.84 | $467.74 |
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 $63.10 Median $63.10 Typical High $104.71 | Professional | 52 · Reduced service | $63.10 | $63.10 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $42.66 | Professional | 53 · Discontinued | $25.12 | $25.12 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $31.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $21.38 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $21.38 |
Where New York sits
The same service costs 50.1 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.