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 $81.28 Median $104.71 Typical High $234.42 | Facility | None | $81.28 | $104.71 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Facility | None | $81.28 | $81.28 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $125.89 | Facility | None | $91.20 | $109.65 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $346.74 | Professional | None | $83.18 | $83.18 | $346.74 |
Emblem Health Setting Facility Modifier None Typical Low $79.43 Median $91.20 Typical High $177.83 | Facility | None | $79.43 | $91.20 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | None | $79.43 | $79.43 | $102.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Facility | None | $81.28 | $81.28 | $83.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | None | $81.28 | $81.28 | $83.18 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $169.82 | Facility | None | $102.33 | $102.33 | $169.82 |
MVP Health Care Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $109.65 | Professional | None | $77.62 | $97.72 | $109.65 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $85.11 Typical High $112.20 | Professional | None | $81.28 | $85.11 | $112.20 |
Univera Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Univera Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $83.18 | Professional | None | $81.28 | $81.28 | $83.18 |
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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where New York sits
The same service costs 1.5 times more in Arizona than in Nebraska. 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
$83.18
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.