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 $309.03 Median $398.11 Typical High $912.01 | Facility | None | $309.03 | $398.11 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Facility | None | $309.03 | $309.03 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $316.23 | Professional | None | $245.47 | $316.23 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $416.87 Typical High $478.63 | Facility | None | $263.03 | $416.87 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $1,318.26 | Professional | None | $316.23 | $316.23 | $1,318.26 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $380.19 Typical High $707.95 | Facility | None | $302.00 | $380.19 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | None | $346.74 | $346.74 | $398.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Facility | None | $309.03 | $309.03 | $323.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $338.84 Median $389.05 Typical High $660.69 | Facility | None | $338.84 | $389.05 | $660.69 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $407.38 | Professional | None | $295.12 | $371.54 | $407.38 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $426.58 | Professional | None | $281.84 | $331.13 | $426.58 |
Univera Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Facility | None | $309.03 | $309.03 | $331.13 |
Univera Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $323.59 | Professional | None | $309.03 | $309.03 | $323.59 |
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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where New York sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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
$316
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.