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 $67.61 Median $79.43 Typical High $199.53 | Facility | None | $67.61 | $79.43 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $74.13 | Professional | None | $67.61 | $67.61 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Facility | None | $67.61 | $67.61 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
CDPHP Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $97.72 Typical High $128.82 | Facility | None | $74.13 | $97.72 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $288.40 | Professional | None | $67.61 | $67.61 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $229.09 | Facility | None | $63.10 | $75.86 | $229.09 |
Emblem Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $190.55 | Professional | None | $67.61 | $67.61 | $190.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Facility | None | $67.61 | $67.61 | $70.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | None | $67.61 | $67.61 | $70.79 |
Highmark BCBS Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $91.20 | Facility | None | $79.43 | $79.43 | $91.20 |
MVP Health Care Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $158.49 | Facility | None | $95.50 | $95.50 | $158.49 |
MVP Health Care Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $67.61 Median $72.44 Typical High $123.03 | Professional | None | $67.61 | $72.44 | $123.03 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Facility | None | $67.61 | $67.61 | $70.79 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | None | $67.61 | $67.61 | $70.79 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where New York sits
The same service costs 2.0 times more in Oklahoma than in New Mexico. 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· 46th of 51
$67.61
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.