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 $97.72 Median $112.20 Typical High $281.84 | Facility | None | $97.72 | $112.20 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $112.20 | Professional | None | $97.72 | $97.72 | $112.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $100.00 | Facility | None | $97.72 | $97.72 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
CDPHP Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $181.97 | Facility | None | $120.23 | $125.89 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $630.96 | Professional | None | $120.23 | $120.23 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $194.98 | Facility | None | $120.23 | $120.23 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $147.91 | Professional | None | $120.23 | $120.23 | $147.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Facility | None | $120.23 | $125.89 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | None | $120.23 | $125.89 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Facility | None | $120.23 | $125.89 | $125.89 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | None | $120.23 | $125.89 | $125.89 |
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 $48.98 Median $48.98 Typical High $56.23 | Professional | 52 · Reduced service | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $22.91 | Professional | 53 · Discontinued | $19.50 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $16.98 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $11.22 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $11.22 |
Highmark BCBS Setting Facility Modifier TB · 340B drug Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | TB · 340B drug | $97.72 | $97.72 | $97.72 |
Where New York sits
The same service costs 2.3 times more in Texas than in Hawaii. 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
$117
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.