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 $51.29 Median $67.61 Typical High $151.36 | Facility | None | $51.29 | $67.61 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Professional | None | $53.70 | $53.70 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $53.70 Typical High $53.70 | Professional | None | $21.88 | $53.70 | $53.70 |
CDPHP Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $70.79 Typical High $85.11 | Facility | None | $25.70 | $70.79 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $218.78 | Professional | None | $53.70 | $53.70 | $218.78 |
Emblem Health Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $120.23 | Facility | None | $51.29 | $64.57 | $120.23 |
Emblem Health Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $69.18 | Professional | None | $58.88 | $58.88 | $69.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $53.70 | Facility | None | $51.29 | $51.29 | $53.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | None | $51.29 | $51.29 | $53.70 |
MVP Health Care Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $107.15 | Facility | None | $60.26 | $60.26 | $107.15 |
MVP Health Care Setting Professional Modifier None Typical Low $1.00 Median $16.60 Typical High $48.98 | Professional | None | $1.00 | $16.60 | $48.98 |
United Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $70.79 | Professional | None | $46.77 | $54.95 | $70.79 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $54.95 | Facility | None | $51.29 | $51.29 | $54.95 |
Univera Setting Professional Modifier None Typical Low $7.24 Median $51.29 Typical High $53.70 | Professional | None | $7.24 | $51.29 | $53.70 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where New York sits
The same service costs 3.0 times more in Arizona than in Oklahoma. 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· 24th of 51
$53.70
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.