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 $91.20 Median $173.78 Typical High $263.03 | Facility | None | $91.20 | $173.78 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $173.78 Typical High $173.78 | Professional | None | $66.07 | $173.78 | $173.78 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $190.55 Typical High $257.04 | Facility | None | $81.28 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $389.05 | Professional | None | $173.78 | $173.78 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $380.19 | Facility | None | $162.18 | $204.17 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $251.19 | Professional | None | $173.78 | $186.21 | $251.19 |
Excellus BCBS Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | None | $91.20 | $91.20 | $95.50 |
MVP Health Care Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $186.21 | Facility | None | $95.50 | $95.50 | $186.21 |
MVP Health Care Setting Professional Modifier None Typical Low $7.08 Median $58.88 Typical High $95.50 | Professional | None | $7.08 | $58.88 | $95.50 |
United Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $138.04 | Professional | None | $81.28 | $97.72 | $138.04 |
Univera Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Facility | None | $91.20 | $91.20 | $95.50 |
Univera Setting Professional Modifier None Typical Low $10.96 Median $91.20 Typical High $95.50 | Professional | None | $10.96 | $91.20 | $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 $87.10 Median $87.10 Typical High $87.10 | Professional | 52 · Reduced service | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $17.38 |
Where New York sits
The same service costs 3.2 times more in Wyoming 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· 28th of 51
$162
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.