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 $89.13 Median $107.15 Typical High $269.15 | Facility | None | $89.13 | $107.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $95.50 | Facility | None | $93.33 | $93.33 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
CDPHP Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $131.83 Typical High $144.54 | Facility | None | $97.72 | $131.83 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $389.05 | Professional | None | $89.13 | $89.13 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $309.03 | Facility | None | $85.11 | $102.33 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $199.53 | Professional | None | $89.13 | $89.13 | $199.53 |
Excellus BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $95.50 | Facility | None | $93.33 | $93.33 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | None | $93.33 | $93.33 | $95.50 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $354.81 | Facility | None | $128.82 | $128.82 | $354.81 |
MVP Health Care Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $162.18 | Professional | None | $93.33 | $97.72 | $162.18 |
Univera Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $97.72 | Facility | None | $93.33 | $93.33 | $97.72 |
Univera Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $95.50 | Professional | None | $93.33 | $93.33 | $95.50 |
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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where New York sits
The same service costs 5.9 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· 36th of 51
$93.33
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.