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 $33.11 Median $42.66 Typical High $52.48 | Facility | None | $33.11 | $42.66 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $43.65 | Professional | None | $33.11 | $33.11 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $63.10 | Professional | None | $45.71 | $53.70 | $63.10 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Emblem Health Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $204.17 | Facility | None | $52.48 | $83.18 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $104.71 | Professional | None | $48.98 | $70.79 | $104.71 |
Excellus BCBS Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $53.70 | Professional | None | $25.12 | $38.90 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $83.18 | Professional | None | $46.77 | $46.77 | $83.18 |
United Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $125.89 | Professional | None | $37.15 | $56.23 | $125.89 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $47.86 Typical High $52.48 | Facility | None | $45.71 | $47.86 | $52.48 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $45.71 Typical High $53.70 | Professional | None | $25.12 | $45.71 | $53.70 |
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 $16.60 Median $16.60 Typical High $21.88 | Professional | 52 · Reduced service | $16.60 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $8.91 | Professional | 53 · Discontinued | $6.61 | $6.61 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $6.61 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $4.37 |
Where New York sits
The same service costs 2.2 times more in Alaska than in Arizona. 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· 33rd of 51
$51.29
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.