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 $89.13 Median $134.90 Typical High $257.04 | Facility | None | $89.13 | $134.90 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $104.71 | Professional | None | $89.13 | $89.13 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $120.23 | Professional | None | $81.28 | $97.72 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $138.04 | Facility | None | $117.49 | $117.49 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $489.78 Typical High $489.78 | Professional | None | $223.87 | $489.78 | $489.78 |
Emblem Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Facility | None | $67.61 | $67.61 | $107.15 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $138.04 | Professional | None | $134.90 | $134.90 | $138.04 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $181.97 | Professional | None | $128.82 | $128.82 | $181.97 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Univera Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $44.67 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $44.67 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $20.89 | Professional | 53 · Discontinued | $17.78 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $10.23 |
Where New York sits
The same service costs 3.7 times more in Alaska than in Arkansas. 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· 50th of 51
$100
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.