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 $40.74 Median $50.12 Typical High $117.49 | Facility | None | $40.74 | $50.12 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | None | $40.74 | $40.74 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | None | $48.98 | $48.98 | $57.54 |
CDPHP Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $48.98 Typical High $85.11 | Facility | None | $39.81 | $48.98 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $263.03 | Professional | None | $50.12 | $50.12 | $263.03 |
Emblem Health Setting Facility Modifier None Typical Low $47.86 Median $54.95 Typical High $107.15 | Facility | None | $47.86 | $54.95 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $61.66 | Professional | None | $50.12 | $50.12 | $61.66 |
Excellus BCBS Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Facility | None | $50.12 | $51.29 | $51.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | None | $50.12 | $51.29 | $51.29 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
MVP Health Care Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $38.02 | Professional | None | $7.08 | $7.08 | $38.02 |
United Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $66.07 | Professional | None | $46.77 | $51.29 | $66.07 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Facility | None | $50.12 | $51.29 | $51.29 |
Univera Setting Professional Modifier None Typical Low $20.89 Median $51.29 Typical High $51.29 | Professional | None | $20.89 | $51.29 | $51.29 |
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 $19.95 Median $19.95 Typical High $23.44 | Professional | 52 · Reduced service | $19.95 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | 53 · Discontinued | $8.13 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.68 |
Where New York sits
The same service costs 1.7 times more in Alaska than in Montana. 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· 49th of 51
$48.98
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.