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 $41.69 Typical High $47.86 | Facility | None | $33.11 | $41.69 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
CDPHP Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $223.87 | Facility | None | $57.54 | $93.33 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $107.15 | Professional | None | $63.10 | $63.10 | $107.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $60.26 | Professional | None | $44.67 | $52.48 | $60.26 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $79.43 | Professional | None | $46.77 | $46.77 | $79.43 |
United Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $70.79 | Professional | None | $37.15 | $46.77 | $70.79 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $60.26 Typical High $60.26 | Facility | None | $52.48 | $60.26 | $60.26 |
Univera Setting Professional Modifier None Typical Low $38.02 Median $45.71 Typical High $60.26 | Professional | None | $38.02 | $45.71 | $60.26 |
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 $22.91 | Professional | 52 · Reduced service | $16.60 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $9.33 | Professional | 53 · Discontinued | $6.61 | $6.61 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $6.92 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $4.57 |
Where New York sits
The same service costs 3.1 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.