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 $120.23 Median $154.88 Typical High $354.81 | Facility | None | $120.23 | $154.88 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $229.09 | Professional | None | $120.23 | $120.23 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $181.97 | Facility | None | $112.20 | $158.49 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $512.86 | Professional | None | $120.23 | $120.23 | $512.86 |
Emblem Health Setting Facility Modifier None Typical Low $114.82 Median $131.83 Typical High $257.04 | Facility | None | $114.82 | $131.83 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | None | $114.82 | $114.82 | $151.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Facility | None | $120.23 | $120.23 | $123.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | None | $120.23 | $120.23 | $123.03 |
MVP Health Care Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $257.04 | Facility | None | $151.36 | $151.36 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $162.18 | Professional | None | $114.82 | $141.25 | $162.18 |
United Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $169.82 | Professional | None | $120.23 | $128.82 | $169.82 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Professional | None | $120.23 | $120.23 | $123.03 |
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 $60.26 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.02 |
Where New York sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 35th of 51
$120
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.