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 $46.77 Median $77.62 Typical High $138.04 | Facility | None | $46.77 | $77.62 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $208.93 | Professional | None | $77.62 | $77.62 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $93.33 Typical High $117.49 | Facility | None | $69.18 | $93.33 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $407.38 | Professional | None | $77.62 | $77.62 | $407.38 |
Emblem Health Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $173.78 | Facility | None | $74.13 | $93.33 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $131.83 | Professional | None | $85.11 | $85.11 | $131.83 |
Excellus BCBS Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $48.98 | Facility | None | $46.77 | $46.77 | $48.98 |
Excellus BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $48.98 | Professional | None | $46.77 | $46.77 | $48.98 |
MVP Health Care Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $177.83 | Facility | None | $51.29 | $51.29 | $177.83 |
MVP Health Care Setting Professional Modifier None Typical Low $8.91 Median $50.12 Typical High $131.83 | Professional | None | $8.91 | $50.12 | $131.83 |
United Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $190.55 | Professional | None | $46.77 | $50.12 | $190.55 |
Univera Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $56.23 | Facility | None | $46.77 | $46.77 | $56.23 |
Univera Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $295.12 | Professional | None | $46.77 | $46.77 | $295.12 |
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 $38.90 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $7.76 |
Where New York sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 13th of 51
$77.62
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.