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 $100.00 Median $147.91 Typical High $288.40 | Facility | None | $100.00 | $147.91 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | None | $100.00 | $100.00 | $114.82 |
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 $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
CDPHP Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $181.97 | Facility | None | $102.33 | $102.33 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $645.65 | Professional | None | $123.03 | $123.03 | $645.65 |
Emblem Health Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $199.53 | Facility | None | $123.03 | $123.03 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $154.88 | Professional | None | $123.03 | $123.03 | $154.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Facility | None | $123.03 | $125.89 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | None | $123.03 | $125.89 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $162.18 | Professional | None | $109.65 | $125.89 | $162.18 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Facility | None | $123.03 | $125.89 | $125.89 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | None | $123.03 | $125.89 | $125.89 |
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 $48.98 Median $48.98 Typical High $57.54 | Professional | 52 · Reduced service | $48.98 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.00 | $10.00 | $11.48 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 42nd 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.