How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $56.23 Median $83.18 Typical High $162.18 | Facility | None | $56.23 | $83.18 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $64.57 | Professional | None | $56.23 | $56.23 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $70.79 | Professional | None | $51.29 | $61.66 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Emblem Health Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $117.49 | Facility | None | $72.44 | $72.44 | $117.49 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
MVP Health Care Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $112.20 | Professional | None | $81.28 | $81.28 | $112.20 |
Univera Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Univera Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $28.18 Median $28.18 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $28.18 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $12.88 | Professional | 53 · Discontinued | $11.22 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.46 |
Where New York sits
The same service costs 1.9 times more in Alabama than in New York. 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· 51st of 51
$64.57
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.