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 $144.54 Median $151.36 Typical High $177.83 | Facility | None | $144.54 | $151.36 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $151.36 Typical High $162.18 | Professional | None | $144.54 | $151.36 | $162.18 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $758.58 | Professional | None | $144.54 | $144.54 | $758.58 |
Emblem Health Setting Facility Modifier None Typical Low $165.96 Median $204.17 Typical High $602.56 | Facility | None | $165.96 | $204.17 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $575.44 | Professional | None | $177.83 | $288.40 | $575.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $208.93 | Professional | None | $151.36 | $177.83 | $208.93 |
MVP Health Care Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $478.63 | Professional | None | $173.78 | $204.17 | $478.63 |
United Setting Professional Modifier None Typical Low $144.54 Median $218.78 Typical High $457.09 | Professional | None | $144.54 | $218.78 | $457.09 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $218.78 | Facility | None | $151.36 | $151.36 | $218.78 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $208.93 | Professional | None | $151.36 | $186.21 | $208.93 |
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 $72.44 Median $75.86 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $30.20 Typical High $32.36 | Professional | 53 · Discontinued | $28.84 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.91 Typical High $24.55 | Professional | 55 · Aftercare only | $21.88 | $22.91 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $15.14 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.45 | $15.14 | $16.22 |
Where New York sits
The same service costs 4.7 times more in Alaska than in Alabama. 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· 48th of 51
$158
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.