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 $95.50 Median $97.72 Typical High $112.20 | Facility | None | $95.50 | $97.72 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $107.15 | Professional | None | $95.50 | $97.72 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $128.82 | Professional | None | $93.33 | $109.65 | $128.82 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $457.09 | Facility | None | $117.49 | $190.55 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | None | $204.17 | $251.19 | $363.08 |
Excellus BCBS Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $58.88 Median $128.82 Typical High $177.83 | Professional | None | $58.88 | $128.82 | $177.83 |
MVP Health Care Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $257.04 | Professional | None | $109.65 | $109.65 | $257.04 |
United Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $275.42 | Professional | None | $89.13 | $134.90 | $275.42 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $165.96 Typical High $173.78 | Facility | None | $120.23 | $165.96 | $173.78 |
Univera Setting Professional Modifier None Typical Low $58.88 Median $128.82 Typical High $177.83 | Professional | None | $58.88 | $128.82 | $177.83 |
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 $47.86 Median $48.98 Typical High $53.70 | Professional | 52 · Reduced service | $47.86 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.50 Typical High $21.38 | Professional | 53 · Discontinued | $19.05 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $15.85 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.77 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.55 | $9.77 | $10.72 |
Where New York sits
The same service costs 2.6 times more in North Dakota than in Delaware. 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· 49th of 51
$107
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.