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 $97.72 | Facility | None | $64.57 | $83.18 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $83.18 | Professional | None | $64.57 | $64.57 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $131.83 | Professional | None | $100.00 | $117.49 | $131.83 |
CDPHP Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $117.49 | Professional | None | $102.33 | $102.33 | $117.49 |
Emblem Health Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $426.58 | Facility | None | $104.71 | $128.82 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $114.82 | Professional | None | $75.86 | $93.33 | $114.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $114.82 | Professional | None | $83.18 | $100.00 | $114.82 |
MVP Health Care Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | None | $114.82 | $114.82 | $120.23 |
United Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $234.42 | Professional | None | $91.20 | $123.03 | $234.42 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $107.15 Typical High $114.82 | Facility | None | $100.00 | $107.15 | $114.82 |
Univera Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $114.82 | Professional | None | $58.88 | $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 $41.69 | Professional | 52 · Reduced service | $32.36 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $12.88 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $12.30 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $8.32 |
Where New York sits
The same service costs 3.0 times more in Alaska than in West 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· 26th of 51
$112
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.