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 $41.69 Median $57.54 Typical High $128.82 | Facility | None | $41.69 | $57.54 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $41.69 | Professional | None | $40.74 | $41.69 | $41.69 |
CDPHP Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $54.95 Typical High $75.86 | Facility | None | $42.66 | $54.95 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $186.21 | Professional | None | $41.69 | $41.69 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $50.12 Typical High $93.33 | Facility | None | $39.81 | $50.12 | $93.33 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $63.10 | Professional | None | $45.71 | $45.71 | $63.10 |
Excellus BCBS Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $45.71 | Facility | None | $44.67 | $44.67 | $45.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | None | $44.67 | $44.67 | $45.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
MVP Health Care Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $109.65 | Facility | None | $43.65 | $43.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $25.12 Median $61.66 Typical High $61.66 | Professional | None | $25.12 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $63.10 | Professional | None | $44.67 | $46.77 | $63.10 |
Univera Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Facility | None | $44.67 | $44.67 | $46.77 |
Univera Setting Professional Modifier None Typical Low $13.49 Median $44.67 Typical High $45.71 | Professional | None | $13.49 | $44.67 | $45.71 |
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 $20.89 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 53 · Discontinued | $8.32 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.17 |
Where New York sits
The same service costs 1.8 times more in Arizona than in Georgia. 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· 22nd of 51
$44.67
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.