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 $38.90 Median $40.74 Typical High $45.71 | Facility | None | $38.90 | $40.74 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | None | $38.90 | $38.90 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $50.12 | Professional | None | $36.31 | $42.66 | $50.12 |
CDPHP Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $79.43 Typical High $190.55 | Facility | None | $50.12 | $79.43 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $181.97 | Professional | None | $100.00 | $123.03 | $181.97 |
Excellus BCBS Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $25.70 Median $64.57 Typical High $87.10 | Professional | None | $25.70 | $64.57 | $87.10 |
MVP Health Care Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $114.82 | Professional | None | $43.65 | $43.65 | $114.82 |
United Setting Professional Modifier None Typical Low $36.31 Median $57.54 Typical High $117.49 | Professional | None | $36.31 | $57.54 | $117.49 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $81.28 Typical High $87.10 | Facility | None | $51.29 | $81.28 | $87.10 |
Univera Setting Professional Modifier None Typical Low $25.70 Median $64.57 Typical High $87.10 | Professional | None | $25.70 | $64.57 | $87.10 |
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 $19.05 Median $19.05 Typical High $22.91 | Professional | 52 · Reduced service | $19.05 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $9.12 | Professional | 53 · Discontinued | $7.76 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.92 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $4.57 |
Where New York sits
The same service costs 3.0 times more in North Dakota 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
$42.66
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.