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 $18.62 Median $18.62 Typical High $43.65 | Facility | None | $18.62 | $18.62 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $20.89 | Professional | None | $18.62 | $18.62 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $19.05 | Facility | None | $18.20 | $18.20 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $27.54 | Facility | None | $20.42 | $24.55 | $27.54 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $77.62 | Professional | None | $18.62 | $18.62 | $77.62 |
Emblem Health Setting Facility Modifier None Typical Low $17.38 Median $20.89 Typical High $63.10 | Facility | None | $17.38 | $20.89 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | None | $18.62 | $18.62 | $23.99 |
Excellus BCBS Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Excellus BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Highmark BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
MVP Health Care Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $39.81 | Facility | None | $22.91 | $22.91 | $39.81 |
MVP Health Care Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $25.12 | Professional | None | $17.78 | $21.88 | $25.12 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $18.20 Median $19.50 Typical High $25.70 | Professional | None | $18.20 | $19.50 | $25.70 |
Univera Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $20.42 | Facility | None | $18.20 | $18.20 | $20.42 |
Univera Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | None | $18.20 | $18.20 | $21.88 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Where New York sits
The same service costs 1.5 times more in Alaska than in Rhode Island. 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· 31st of 51
$18.62
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.