How much rates vary
Facilitymedian $15 · 10th to 90th $11 to $20Professionalmedian $12 · 10th to 90th $11 to $19
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 $11.22 Median $11.22 Typical High $33.88 | Facility | None | $11.22 | $11.22 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | None | $11.22 | $11.22 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.49 | Facility | None | $15.14 | $15.14 | $15.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
CDPHP Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $16.22 Typical High $20.42 | Facility | None | $12.30 | $16.22 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $63.10 | Professional | None | $11.22 | $11.22 | $63.10 |
Emblem Health Setting Facility Modifier None Typical Low $10.72 Median $12.88 Typical High $23.99 | Facility | None | $10.72 | $12.88 | $23.99 |
Emblem Health Setting Professional Modifier None Typical Low $11.75 Median $11.75 Typical High $22.39 | Professional | None | $11.75 | $11.75 | $22.39 |
Excellus BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.49 | Facility | None | $15.14 | $15.14 | $15.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | None | $15.14 | $15.14 | $15.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Facility | None | $18.62 | $18.62 | $25.70 |
MVP Health Care Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $38.90 | Facility | None | $19.95 | $19.95 | $38.90 |
MVP Health Care Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | None | $15.85 | $19.95 | $19.95 |
United Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.85 Typical High $20.89 | Professional | None | $15.14 | $15.85 | $20.89 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.85 | Facility | None | $15.14 | $15.14 | $15.85 |
Univera Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | None | $15.14 | $15.14 | $15.49 |
5 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 $5.62 Median $5.62 Typical High $5.62 | Professional | 52 · Reduced service | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 53 · Discontinued | $2.24 | $2.24 | $2.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 54 · Surgery only | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Where New York sits
The same service costs 1.9 times more in Texas 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· 39th of 51
$14.79
TX $21.88GA $11.22
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.