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 $64.57 Median $83.18 Typical High $104.71 | Facility | None | $64.57 | $83.18 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $87.10 | Professional | None | $64.57 | $64.57 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $125.89 | Professional | None | $91.20 | $107.15 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Emblem Health Setting Facility Modifier None Typical Low $109.65 Median $177.83 Typical High $426.58 | Facility | None | $109.65 | $177.83 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $229.09 | Professional | None | $120.23 | $147.91 | $229.09 |
Excellus BCBS Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $114.82 | Professional | None | $48.98 | $95.50 | $114.82 |
MVP Health Care Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $181.97 | Professional | None | $93.33 | $93.33 | $181.97 |
United Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $245.47 | Professional | None | $74.13 | $112.20 | $245.47 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $112.20 | Facility | None | $97.72 | $100.00 | $112.20 |
Univera Setting Professional Modifier None Typical Low $48.98 Median $95.50 Typical High $114.82 | Professional | None | $48.98 | $95.50 | $114.82 |
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 $32.36 Median $32.36 Typical High $43.65 | Professional | 52 · Reduced service | $32.36 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $13.18 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $12.88 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $8.71 |
Where New York sits
The same service costs 2.2 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· 36th of 51
$102
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.