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 $56.23 Median $57.54 Typical High $67.61 | Facility | None | $56.23 | $57.54 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $63.10 | Professional | None | $56.23 | $57.54 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $75.86 | Professional | None | $54.95 | $64.57 | $75.86 |
CDPHP Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Emblem Health Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $302.00 | Facility | None | $79.43 | $125.89 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | None | $87.10 | $107.15 | $162.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $34.67 Median $58.88 Typical High $81.28 | Professional | None | $34.67 | $58.88 | $81.28 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $138.04 | Professional | None | $67.61 | $67.61 | $138.04 |
United Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $173.78 | Professional | None | $53.70 | $79.43 | $173.78 |
Univera Setting Facility Modifier None Typical Low $69.18 Median $70.79 Typical High $79.43 | Facility | None | $69.18 | $70.79 | $79.43 |
Univera Setting Professional Modifier None Typical Low $34.67 Median $69.18 Typical High $81.28 | Professional | None | $34.67 | $69.18 | $81.28 |
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 $28.18 Median $28.84 Typical High $31.62 | Professional | 52 · Reduced service | $28.18 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.48 Typical High $12.59 | Professional | 53 · Discontinued | $11.22 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $6.31 |
Where New York sits
The same service costs 2.5 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· 46th of 51
$63.10
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.