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 $43.65 Median $43.65 Typical High $123.03 | Facility | None | $43.65 | $43.65 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $43.65 | Facility | None | $42.66 | $42.66 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
CDPHP Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $56.23 Typical High $64.57 | Facility | None | $38.90 | $56.23 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $181.97 | Professional | None | $43.65 | $43.65 | $181.97 |
Emblem Health Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $93.33 | Facility | None | $40.74 | $46.77 | $93.33 |
Emblem Health Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None | $42.66 | $42.66 | $54.95 |
Excellus BCBS Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Facility | None | $42.66 | $42.66 | $44.67 |
Excellus BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
Highmark BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $91.20 | Facility | None | $53.70 | $53.70 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $57.54 | Professional | None | $41.69 | $51.29 | $57.54 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $58.88 | Professional | None | $42.66 | $45.71 | $58.88 |
Univera Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Facility | None | $42.66 | $42.66 | $44.67 |
Univera Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | None | $42.66 | $42.66 | $44.67 |
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 $21.88 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $4.37 |
Where New York sits
The same service costs 1.6 times more in Arizona than in Maryland. 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· 27th of 51
$43.65
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.