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 $27.54 Median $30.90 Typical High $33.11 | Facility | None | $27.54 | $30.90 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | None | $27.54 | $27.54 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $43.65 | Professional | None | $33.11 | $38.90 | $43.65 |
CDPHP Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Emblem Health Setting Facility Modifier None Typical Low $21.88 Median $46.77 Typical High $158.49 | Facility | None | $21.88 | $46.77 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $60.26 | Professional | None | $47.86 | $47.86 | $60.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $54.95 | Professional | None | $32.36 | $33.11 | $54.95 |
MVP Health Care Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $52.48 | Professional | None | $37.15 | $37.15 | $52.48 |
United Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $107.15 | Facility | None | $75.86 | $87.10 | $107.15 |
United Setting Professional Modifier None Typical Low $23.99 Median $31.62 Typical High $44.67 | Professional | None | $23.99 | $31.62 | $44.67 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $44.67 | Facility | None | $38.02 | $43.65 | $44.67 |
Univera Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $43.65 | Professional | None | $22.91 | $33.11 | $43.65 |
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 $13.80 Median $13.80 Typical High $16.60 | Professional | 52 · Reduced service | $13.80 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $6.61 | Professional | 53 · Discontinued | $5.50 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.90 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $3.31 |
Where New York sits
The same service costs 12.9 times more in Hawaii 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· 39th of 51
$37.15
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.