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 $33.11 Median $39.81 Typical High $46.77 | Facility | None | $33.11 | $39.81 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $44.67 | Professional | None | $33.11 | $33.11 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $213.80 | Facility | None | $56.23 | $91.20 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $104.71 | Professional | None | $61.66 | $61.66 | $104.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $57.54 | Professional | None | $42.66 | $50.12 | $57.54 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $77.62 | Professional | None | $46.77 | $46.77 | $77.62 |
United Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $69.18 | Professional | None | $36.31 | $45.71 | $69.18 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $57.54 Typical High $57.54 | Facility | None | $50.12 | $57.54 | $57.54 |
Univera Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $57.54 | Professional | None | $36.31 | $50.12 | $57.54 |
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 $16.60 Median $16.60 Typical High $22.39 | Professional | 52 · Reduced service | $16.60 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $8.91 | Professional | 53 · Discontinued | $6.61 | $6.61 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $6.76 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $4.47 |
Where New York sits
The same service costs 3.0 times more in Alaska than in New York. 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· 51st of 51
$46.77
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.