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 $1,122.02 Median $1,380.38 Typical High $3,235.94 | Facility | None | $1,122.02 | $1,380.38 | $3,235.94 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $1,230.27 Typical High $2,511.89 | Professional | None | $0.02 | $1,230.27 | $2,511.89 |
CDPHP Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,513.56 Typical High $2,137.96 | Facility | None | $776.25 | $1,513.56 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,445.44 | $1,445.44 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $3,019.95 | Facility | None | $1,318.26 | $1,513.56 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,445.44 | $1,698.24 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,380.38 | $1,479.11 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $575.44 | Facility | None | $489.78 | $575.44 | $575.44 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $616.60 | Professional | None | $489.78 | $575.44 | $616.60 |
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 $562.34 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $128.82 |
Where New York sits
The same service costs 3.0 times more in Arizona than in Montana. 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
$1,380
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.