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 $60.26 Median $63.10 Typical High $74.13 | Facility | None | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $67.61 | Professional | None | $60.26 | $63.10 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $83.18 | Professional | None | $60.26 | $70.79 | $83.18 |
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 $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Emblem Health Setting Facility Modifier None Typical Low $87.10 Median $138.04 Typical High $331.13 | Facility | None | $87.10 | $138.04 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $169.82 | Professional | None | $95.50 | $114.82 | $169.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Excellus BCBS Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $87.10 | Professional | None | $38.02 | $63.10 | $87.10 |
MVP Health Care Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $151.36 | Professional | None | $74.13 | $74.13 | $151.36 |
United Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $190.55 | Professional | None | $57.54 | $87.10 | $190.55 |
Univera Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $85.11 | Facility | None | $74.13 | $79.43 | $85.11 |
Univera Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $87.10 | Professional | None | $38.02 | $74.13 | $87.10 |
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 $30.20 Median $31.62 Typical High $33.88 | Professional | 52 · Reduced service | $30.20 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.59 Typical High $13.49 | Professional | 53 · Discontinued | $12.30 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.76 |
Where New York sits
The same service costs 2.6 times more in Alaska than in Arizona. 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· 45th of 51
$67.61
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.