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 $54.95 Median $91.20 Typical High $602.56 | Facility | None | $54.95 | $91.20 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $602.56 | Professional | None | $54.95 | $54.95 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $794.33 | Professional | None | $223.87 | $346.74 | $794.33 |
CDPHP Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $549.54 | Facility | None | $141.25 | $229.09 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $457.09 | Professional | None | $257.04 | $257.04 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $169.82 Median $707.95 Typical High $977.24 | Professional | None | $169.82 | $707.95 | $977.24 |
MVP Health Care Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $281.84 | Professional | None | $190.55 | $190.55 | $281.84 |
United Setting Facility Modifier None Typical Low $4,168.69 Median $4,786.30 Typical High $6,025.60 | Facility | None | $4,168.69 | $4,786.30 | $6,025.60 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $288.40 | Professional | None | $104.71 | $158.49 | $288.40 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $812.83 Typical High $812.83 | Facility | None | $707.95 | $812.83 | $812.83 |
Univera Setting Professional Modifier None Typical Low $169.82 Median $707.95 Typical High $977.24 | Professional | None | $169.82 | $707.95 | $977.24 |
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 $27.54 Median $27.54 Typical High $302.00 | Professional | 52 · Reduced service | $27.54 | $27.54 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $120.23 | Professional | 53 · Discontinued | $10.96 | $10.96 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $91.20 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $60.26 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $60.26 |
Where New York sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 30th of 51
$191
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.