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 $72.44 Median $89.13 Typical High $102.33 | Facility | None | $72.44 | $89.13 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
CDPHP Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Emblem Health Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $478.63 | Facility | None | $125.89 | $204.17 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $234.42 | Professional | None | $138.04 | $138.04 | $234.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $125.89 | Professional | None | $93.33 | $109.65 | $125.89 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $169.82 | Professional | None | $102.33 | $102.33 | $169.82 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $151.36 | Professional | None | $81.28 | $100.00 | $151.36 |
Univera Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $128.82 | Facility | None | $109.65 | $125.89 | $128.82 |
Univera Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $125.89 | Professional | None | $79.43 | $97.72 | $125.89 |
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 $36.31 Median $36.31 Typical High $50.12 | Professional | 52 · Reduced service | $36.31 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $19.95 | Professional | 53 · Discontinued | $14.45 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $10.00 |
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
$102
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.