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 $630.96 Median $776.25 Typical High $1,905.46 | Facility | None | $630.96 | $776.25 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | None | $660.69 | $660.69 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $2,290.87 | Professional | None | $794.33 | $794.33 | $2,290.87 |
CDPHP Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $2,951.21 | Facility | None | $912.01 | $1,621.81 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $4,365.16 | Professional | None | $812.83 | $812.83 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $1,071.52 Typical High $2,398.83 | Facility | None | $776.25 | $1,071.52 | $2,398.83 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | None | $812.83 | $812.83 | $1,071.52 |
Excellus BCBS Setting Facility Modifier None Typical Low $812.83 Median $851.14 Typical High $851.14 | Facility | None | $812.83 | $851.14 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | None | $812.83 | $851.14 | $851.14 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,479.11 | $2,818.38 |
United Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,445.44 | Professional | None | $794.33 | $851.14 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $851.14 Typical High $851.14 | Facility | None | $812.83 | $851.14 | $851.14 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $851.14 Typical High $851.14 | Professional | None | $60.26 | $851.14 | $851.14 |
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 $331.13 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $77.62 |
Where New York sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 48th of 51
$794
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.