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 $12.88 Median $21.88 Typical High $30.20 | Facility | None | $12.88 | $21.88 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $23.44 Typical High $30.20 | Professional | None | $12.88 | $23.44 | $30.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $45.71 | Professional | None | $30.90 | $36.31 | $45.71 |
CDPHP Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $53.70 | Professional | None | $28.84 | $28.84 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Emblem Health Setting Facility Modifier None Typical Low $19.05 Median $40.74 Typical High $70.79 | Facility | None | $19.05 | $40.74 | $70.79 |
Emblem Health Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | None | $38.90 | $38.90 | $77.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $42.66 | Professional | None | $30.90 | $36.31 | $42.66 |
Highmark BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | None | $91.20 | $91.20 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Professional | None | $40.74 | $40.74 | $52.48 |
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 $13.49 Median $26.92 Typical High $44.67 | Professional | None | $13.49 | $26.92 | $44.67 |
Univera Setting Facility Modifier None Typical Low $18.62 Median $21.38 Typical High $21.38 | Facility | None | $18.62 | $21.38 | $21.38 |
Univera Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $42.66 | Professional | None | $26.30 | $36.31 | $42.66 |
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 $6.46 Median $11.75 Typical High $15.14 | Professional | 52 · Reduced service | $6.46 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $3.47 Typical High $4.57 | Professional | 55 · Aftercare only | $1.95 | $3.47 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.34 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.29 | $2.34 | $3.02 |
Where New York sits
The same service costs 2.6 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· 34th of 51
$34.67
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.