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 $28.18 Median $33.11 Typical High $45.71 | Facility | None | $28.18 | $33.11 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $37.15 | Professional | None | $28.18 | $28.18 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $45.71 | Professional | None | $33.11 | $38.90 | $45.71 |
CDPHP Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $213.80 | Facility | None | $56.23 | $91.20 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $109.65 | Professional | None | $61.66 | $77.62 | $109.65 |
Excellus BCBS Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.95 Median $37.15 Typical High $51.29 | Professional | None | $19.95 | $37.15 | $51.29 |
MVP Health Care Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $79.43 | Professional | None | $38.90 | $38.90 | $79.43 |
United Setting Professional Modifier None Typical Low $33.88 Median $45.71 Typical High $97.72 | Professional | None | $33.88 | $45.71 | $97.72 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $48.98 Typical High $50.12 | Facility | None | $43.65 | $48.98 | $50.12 |
Univera Setting Professional Modifier None Typical Low $19.95 Median $43.65 Typical High $51.29 | Professional | None | $19.95 | $43.65 | $51.29 |
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 $14.13 Median $14.13 Typical High $18.62 | Professional | 52 · Reduced service | $14.13 | $14.13 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $7.59 | Professional | 53 · Discontinued | $5.62 | $5.62 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $3.72 |
Where New York sits
The same service costs 2.6 times more in North Dakota than in Ohio. 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· 44th of 51
$38.02
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.