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 $25.70 Median $39.81 Typical High $51.29 | Facility | None | $25.70 | $39.81 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $39.81 Typical High $51.29 | Professional | None | $25.70 | $39.81 | $51.29 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | None | $60.26 | $63.10 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $58.88 Typical High $77.62 | Professional | None | $48.98 | $58.88 | $77.62 |
CDPHP Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $91.20 | Professional | None | $58.88 | $58.88 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Emblem Health Setting Facility Modifier None Typical Low $38.90 Median $52.48 Typical High $131.83 | Facility | None | $38.90 | $52.48 | $131.83 |
Emblem Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $128.82 | Professional | None | $77.62 | $77.62 | $128.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $70.79 | Professional | None | $51.29 | $60.26 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $91.20 | Professional | None | $54.95 | $54.95 | $91.20 |
United Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $380.19 | Facility | None | $269.15 | $309.03 | $380.19 |
United Setting Professional Modifier None Typical Low $27.54 Median $45.71 Typical High $77.62 | Professional | None | $27.54 | $45.71 | $77.62 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $42.66 Typical High $42.66 | Facility | None | $37.15 | $42.66 | $42.66 |
Univera Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $70.79 | Professional | None | $43.65 | $60.26 | $70.79 |
3 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 $12.88 Median $19.95 Typical High $25.70 | Professional | 52 · Reduced service | $12.88 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $6.03 Typical High $7.76 | Professional | 55 · Aftercare only | $3.89 | $6.03 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.98 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.57 | $3.98 | $5.13 |
Where New York sits
The same service costs 2.3 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· 43rd of 51
$54.95
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.