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 $891.25 Median $1,096.48 Typical High $2,570.40 | Facility | None | $891.25 | $1,096.48 | $2,570.40 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | None | $891.25 | $891.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,071.52 | Professional | None | $741.31 | $1,071.52 | $1,071.52 |
CDPHP Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,621.81 | Facility | None | $436.52 | $436.52 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $5,754.40 | Professional | None | $1,096.48 | $1,096.48 | $5,754.40 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $1,698.24 | Facility | None | $446.68 | $1,047.13 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Facility | None | $1,071.52 | $1,071.52 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Professional | None | $1,071.52 | $1,071.52 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $457.09 | Professional | None | $389.05 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,479.11 | Professional | None | $954.99 | $1,122.02 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,096.48 | Facility | None | $1,071.52 | $1,071.52 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $1,071.52 Typical High $1,096.48 | Professional | None | $234.42 | $1,071.52 | $1,096.48 |
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 $446.68 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $102.33 |
Where New York sits
The same service costs 8.3 times more in Arizona than in Montana. 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· 38th of 51
$1,072
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.